Organization
KELLY BUSINESS VENTURES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW KELLY (OWNER)
(706) 615-9994
Entity
Organization
Contact information
Practice address
1325 LEE ROAD 212, PHENIX CITY, AL 36870-8489
(706) 615-9994
Mailing address
1325 LEE ROAD 212, PHENIX CITY, AL 36870-8489
(706) 615-9994
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
07/14/2016
Last updated
07/14/2016
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