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1912084013
KIM KERRY NEELY
CHARLOTTE, NC
NPI
1912084013
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NC 102318)
Enumeration Date
2006-11-01
Last Update Date
2016-04-18
Business Address
-- KIM KERRY NEELY PAC
3627 BEATTIES FORD RD
CHARLOTTE, NC 28216-3249
Phone number: 704-335-0806
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Mailing Address
-- KIM KERRY NEELY PAC
12102 BOTTLEBRUSH PL
CHARLOTTE, NC 28277-1793
Phone number: 704-752-0130
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