Individual
KELLY BEVERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2001 PROFESSIONAL PKWY STE 200, WOODSTOCK, GA 30188-6444
(844) 543-8437
Mailing address
2943 GOVERNORS CT, MARIETTA, GA 30066-5273
(256) 665-6894
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT015807
GA
225100000X
Physical Therapist
—
—
Other
Enumeration date
03/15/2022
Last updated
03/15/2022
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