Jo Ellen Sullivan Kanne

NPI #1962113803 in Crystal, Minnesota

Provider Information

NPI Number: 1962113803
Entity Type: Individual
Name: Jo Ellen Sullivan Kanne
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Enumeration Date: Dec 12, 2022
Last Updated: Dec 12, 2022

Practice Location

Address: 5747 W BROADWAY AVE STE 112
City: Crystal
State: Minnesota
ZIP Code: 55428-3881
Phone: (612) 205-3079

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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