Individual
AMANDA KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8 CLEMSON RD, PARLIN, NJ 08859-1206
(732) 947-0335
Mailing address
8 CLEMSON RD, PARLIN, NJ 08859-1206
(732) 947-0335
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00201700
NJ
Other
Enumeration date
04/06/2016
Last updated
04/06/2016
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