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1497167845
KELLY DETHERAGE
ORLANDO, FL
NPI
1497167845
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2014-05-20
Last Update Date
2014-10-16
Business Address
-- KELLY DETHERAGE
601 W MICHIGAN ST
ORLANDO, FL 32805-6203
Phone number: 407-317-7430
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Mailing Address
-- KELLY DETHERAGE
601 W MICHIGAN ST
ORLANDO, FL 32805-6203
Phone number: 407-317-7430
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