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1508135252
JOHN KELLY
LAKE WORTH, FL
NPI
1508135252
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Other Name
JACK KELLY
Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: FL 3217)
Enumeration Date
2011-12-27
Last Update Date
2011-12-27
Business Address
Mr. JOHN KELLY
4550 LANTANA ROAD SUITE A4
LAKE WORTH, FL 33463
Phone number: 561-340-7259
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Mailing Address
Mr. JOHN KELLY
9170 SW 14TH ST APT 4107
BOCA RATON, FL 33428-6829
Phone number: 561-603-1807
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