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1285952101
DAN DALE KELLY
SHADY COVE, OR
NPI
1285952101
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
372600000X Adult Companion
Additional Taxonomies
172A00000X Driver
372500000X Chore Provider
Enumeration Date
2010-05-17
Last Update Date
2010-05-17
Business Address
Mr. DAN DALE KELLY
120 BIRCH ST
SHADY COVE, OR 97539
Phone number: 541-878-2429
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Mailing Address
Mr. DAN DALE KELLY
PO BOX 1516
SHADY COVE, OR 97539
Phone number: 541-878-2429
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