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1760906580
TIMOTHY WHITE KELLY
CHARLOTTE, NC
NPI
1760906580
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: NC 1403)
Enumeration Date
2017-08-02
Last Update Date
2017-08-02
Business Address
TIMOTHY WHITE KELLY MED ATC-L
9502 PROVIDENCE RD
CHARLOTTE, NC 28277-8695
Phone number: 704-846-7219
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Mailing Address
TIMOTHY WHITE KELLY MED ATC-L
9502 PROVIDENCE RD
CHARLOTTE, NC 28277-8695
Phone number: 704-846-7219
Copy
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