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Organization

HENRY ALBERT KELLY JR

Active
Other names
Kelly & Associates
Organization subpart
No

Provider details

NPI number
Authorized official
DR. HENRY ALBERT KELLY JR. MHPA, PH.D (MHPA, PH.D)
(910) 747-5215
Entity
Organization

Contact information

Practice address
4124 FIRWOOD LN APT L, CHARLOTTE, NC 28209-2724
(910) 747-5215
Mailing address
4124 FIRWOOD LN APT L, CHARLOTTE, NC 28209-2724
(910) 747-5215

Taxonomy

Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
1046352
TN

Other

Enumeration date
04/09/2015
Last updated
04/09/2015
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