Individual
BRENDA KELLEY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PTA1770
Contact information
Practice address
1003 EVERGREEN DR, JONESBORO, AR 72401-9783
(870) 886-8715
(870) 886-2653
Mailing address
1003 EVERGREEN DR, JONESBORO, AR 72401-9783
(870) 886-8715
(870) 886-2653
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PTA1770
AR
Other
Enumeration date
01/14/2006
Last updated
07/09/2007
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