Individual
EDWARD LAWRENCE KELLY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
711 S VINE ST, GLENWOOD, IA 51534-1927
(712) 525-1344
Mailing address
709 WASHINGTON AVE, RED OAK, IA 51566-2439
(712) 623-6862
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P12593
IA
Other
Enumeration date
01/15/2008
Last updated
01/15/2008
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