Individual
MR. JEFFERY JEANE KELLEY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
205 ASHLEY PL APT 2, EDWARDSVILLE, IL 62025-3541
(618) 910-0942
Mailing address
205 ASHLEY PL APT 2, EDWARDSVILLE, IL 62025-3541
(618) 910-0942
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
04/14/2021
Last updated
04/14/2021
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