Individual
KELLY LYNNE KEITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
121 W HERRICK AVE, WELLINGTON, OH 44090
(440) 752-1078
Mailing address
121 W HERRICK AVE, WELLINGTON, OH 44090-1239
(440) 752-1078
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN356616
OH
Other
Enumeration date
06/08/2017
Last updated
07/21/2022
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