Individual
DEKOTA KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
395 N 6TH ST, WYTHEVILLE, VA 24382-2202
(276) 620-7139
Mailing address
1045 S 4 1/2 ST, WYTHEVILLE, VA 24382-3566
(276) 228-2273
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
VA
Other
Enumeration date
10/12/2021
Last updated
10/12/2021
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