Individual
KELLIE HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
201 W 9TH NORTH ST, SUMMERVILLE, SC 29483-6721
(843) 804-7033
Mailing address
106 BLUE HERON DR, SUMMERVILLE, SC 29485-5402
(419) 584-6497
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
3851
SC
Other
Enumeration date
02/11/2019
Last updated
02/11/2019
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