Individual
MS. MACKENZIE ROSE KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1586 BLOOMINGDALE AVE, VALRICO, FL 33596-6101
(813) 978-9700
(813) 558-6185
Mailing address
13020 N TELECOM PKWY, TEMPLE TERRACE, FL 33637-0925
(813) 978-9700
(813) 558-6185
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL6350
FL
Other
Enumeration date
05/06/2022
Last updated
05/06/2022
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