Individual
IVY KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
101 2ND ST STE 201, SUTTON, WV 26601-1303
(304) 765-3668
(304) 471-2488
Mailing address
499 POWELLS CREEK RD, BIRCH RIVER, WV 26610-8000
(304) 689-1941
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
05/15/2026
Last updated
05/15/2026
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