Individual
JEANNINE YVETTE KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2176 LISTON AVE, COLUMBUS, OH 43207-2834
(614) 817-5295
Mailing address
2176 LISTON AVE, COLUMBUS, OH 43207-2834
(614) 817-5295
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
Primary
—
—
Other
Enumeration date
11/29/2022
Last updated
11/29/2022
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