Individual
KELLY LYNN MATTINGLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
140 DOVER ST, SHELBYVILLE, TN 37160-2776
(931) 684-3426
Mailing address
140 DOVER ST, SHELBYVILLE, TN 37160-2776
(931) 684-3426
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
97700
TN
Other
Enumeration date
04/06/2023
Last updated
04/06/2023
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