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Individual

MRS. TERESA ALICE KELLY-BERRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
250 WAMPANOAG TRL, SUITE301, RIVERSIDE, RI 02915-2218
(401) 451-1234
Mailing address
250 WAMPANOAG TRL, SUITE301, RIVERSIDE, RI 02915-2218
(401) 451-1234

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT00638
RI

Other

Enumeration date
08/01/2006
Last updated
07/08/2007
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