Individual
KELLY DANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
1043 JACK VEST DRIVE, JOHNSON CITY, TN 37614
(423) 439-4044
Mailing address
1815 MERRYWOOD DR APT 2, JOHNSON CITY, TN 37604-8715
(770) 714-3863
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/30/2023
Last updated
06/30/2023
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