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1043611783
JERRY KELLY
FORT STEWART, GA
NPI
1043611783
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171000000X Military Health Care Provider
(Licence: E3038628)
Enumeration Date
2014-09-12
Last Update Date
2014-09-12
Business Address
-- JERRY KELLY
1061 HARMON AVE
FORT STEWART, GA 31314-5641
Phone number: 912-435-5211
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Mailing Address
-- JERRY KELLY
1061 HARMON AVE
FORT STEWART, GA 31314-5641
Phone number: 912-435-5211
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