Organization
DR KC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELECHI OGBONNAYA (OWNER)
(423) 367-7670
Entity
Organization
Contact information
Practice address
2320 PENDRAGON RD, KINGSPORT, TN 37660-2937
(423) 367-7670
Mailing address
2320 PENDRAGON RD, KINGSPORT, TN 37660-2937
(423) 367-7670
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
03/23/2026
Last updated
03/23/2026
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