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1699449868
KELLY VICTOR
LAKELAND, FL
NPI
1699449868
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
343900000X Non-emergency Medical Transport (VAN)
(Licence: FL v236500834590)
Enumeration Date
2021-08-02
Last Update Date
2021-08-02
Business Address
KELLY VICTOR
2880 MINE AND MILL RD
LAKELAND, FL 33801-7008
Phone number: 863-500-2705
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Mailing Address
KELLY VICTOR
1128 N NEW YORK AVE
LAKELAND, FL 33805-4416
Phone number: 863-500-2705
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