Individual
KELLEY PATTON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
6475 VAN BUREN ST, SUITE 102, DAPHNE, AL 36526-7585
(251) 626-9052
(251) 626-5384
Mailing address
9392 CHAMBERLAIN LN, DAPHNE, AL 36526-6032
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH1593
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51514018
BLUE CROSS/BLUE SHIELD
AL
01
—
630997518
COMMERCIAL
AL
Enumeration date
07/20/2005
Last updated
07/08/2007
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