Individual provider · Type 1 NPI
Kellie P. Vernon, LMBT S.C.#4771
Massage Therapist · Marietta, SC
NPI number
1821363094
Active
Practice location
275 Wildazalea Lane
Marietta, SC 29661
Fax (864) 836-8101
Mailing address
P.o. Box 959
Marietta, SC 29661
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Massage Therapist Primary | 225700000X | 4771 (SC) |
Massage Therapist: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.
About NPI 1821363094
Kellie P. Vernon, LMBT S.C.#4771's National Provider Identifier is 1821363094, issued on Mar 20, 2012. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Marietta, SC. The record was last updated on Mar 20, 2012.