Kelly Marie Severson

NPI #1538486428 in Blaine, Minnesota

Provider Information

NPI Number: 1538486428
Entity Type: Individual
Name: Kelly Marie Severson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Massage Therapist
Enumeration Date: May 1, 2010
Last Updated: May 1, 2010

Practice Location

Address: 1061 109TH AVE NE STE D
City: Blaine
State: Minnesota
ZIP Code: 55434-3847
Phone: (612) 203-4835

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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