Individual
AGNES M KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
3107 FREDERICK AVE STE B, SAINT JOSEPH, MO 64506-3082
(816) 233-9888
(816) 233-0414
Mailing address
1013 GEORGE ST, ATCHISON, KS 66002-2637
(314) 498-0257
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
24-00797
KS
Other
Enumeration date
06/17/2024
Last updated
06/17/2024
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