Individual
MICHAEL R KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
458 TALCOTTVILLE RD, VERNON, CT 06066-4052
(860) 875-6156
(860) 872-3828
Mailing address
458 TALCOTTVILLE RD, VERNON, CT 06066-4052
(860) 875-6156
(860) 872-3828
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
000733
CT
Other
Enumeration date
07/02/2015
Last updated
07/02/2015
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