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1114523446
BRENDA KELLY
LOGAN, WV
NPI
1114523446
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
376J00000X Homemaker
Enumeration Date
2020-12-10
Last Update Date
2020-12-11
Business Address
BRENDA KELLY
699 STRATTON ST
LOGAN, WV 25601-4020
Phone number: 304-752-6868
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Mailing Address
BRENDA KELLY
PO BOX 1346
LOGAN, WV 25601-1346
Phone number: 304-752-6868
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