Individual
ALEXIS T KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
217 TOLBERT ST, WADSWORTH, OH 44281-1522
(234) 788-8910
Mailing address
217 TOLBERT ST, WADSWORTH, OH 44281-1522
(234) 788-8910
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
5213496
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0182456
—
OH
Enumeration date
11/13/2020
Last updated
11/13/2020
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