Individual
HARTY TILTON KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
37203 SE WILDCAT MOUNTAIN DR, EAGLE CREEK, OR 97022-9696
(585) 880-5329
Mailing address
PO BOX 448, EAGLE CREEK, OR 97022-0448
(585) 880-5329
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
196966
OR
Other
Enumeration date
01/13/2020
Last updated
01/13/2020
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