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1417030461
JACK KELLEY
HOPKINSVILLE, KY
NPI
1417030461
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2006-10-23
Last Update Date
2007-07-08
Business Address
-- JACK KELLEY
607 HAMMOND PLZ
HOPKINSVILLE, KY 42240-4971
Phone number: 270-886-2205
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Mailing Address
-- JACK KELLEY
PO BOX 614
HOPKINSVILLE, KY 42241-0614
Phone number:
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