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1215184056
KELLY MACK
IRMO, SC
NPI
1215184056
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2251P0200X Physical Therapist Pediatrics
(Licence: SC 2278)
Enumeration Date
2008-08-23
Last Update Date
2008-08-23
Business Address
KELLY MACK PT
107 HOLLY CREEK DR
IRMO, SC 29063-8918
Phone number: 803-749-1625
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Mailing Address
KELLY MACK PT
107 HOLLY CREEK DR
IRMO, SC 29063-8918
Phone number:
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