Individual
KELLY I HOWARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
150 MARY AVE, SUITE1, NIPOMO, CA 93444-7820
(805) 929-3230
(805) 929-3232
Mailing address
680 WESTERN, LOVELOCK, NV 89419
(775) 575-5508
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT4454
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AT4454
PTA LICENSE
CA
Enumeration date
07/27/2006
Last updated
01/14/2016
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