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1891344024
EDWARD ROBERT KELLY
ITHACA, NY
NPI
1891344024
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: NY 000039)
Enumeration Date
2019-09-10
Last Update Date
2019-09-10
Business Address
EDWARD ROBERT KELLY
512 N CAMPUS
ITHACA, NY 14853-6007
Phone number: 607-255-4237
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Mailing Address
EDWARD ROBERT KELLY
214 E UPLAND RD
ITHACA, NY 14850-2255
Phone number: 607-255-4237
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