Individual
LARRY KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6805 NE LOOP 820, SUITE 408, FORT WORTH, TX 76180-6687
(817) 581-7246
(817) 581-7248
Mailing address
6805 NE LOOP 820, SUITE 408, FORT WORTH, TX 76180-6687
(817) 581-7246
(817) 581-7248
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
Other
Enumeration date
03/20/2014
Last updated
03/20/2014
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