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1114145653
KELLY SOUTHARD
GREENVILLE, SC
NPI
1114145653
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: SC 1953)
Enumeration Date
2007-04-22
Last Update Date
2007-07-08
Business Address
Mrs. KELLY SOUTHARD
3400 ANDERSON RD STE C
GREENVILLE, SC 29611-7651
Phone number: 864-295-9890
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Mailing Address
Mrs. KELLY SOUTHARD
300 DUNHILL DR
ANDERSON, SC 29625-5209
Phone number: 864-375-1235
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