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1245824804
PATRICK K KELLEY
VIROQUA, WI
NPI
1245824804
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI 16004)
Enumeration Date
2021-02-24
Last Update Date
2021-02-24
Business Address
Mr. PATRICK K KELLEY CSAC,ICS
1321 N MAIN ST
VIROQUA, WI 54665-1156
Phone number: 608-637-7052
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Mailing Address
Mr. PATRICK K KELLEY CSAC,ICS
1707 MAIN ST
LA CROSSE, WI 54601-4200
Phone number: 608-785-0001
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