Individual
BENJAMIN KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PRS
Contact information
Practice address
9620 CAREYS RUN POND CREEK RD, MC DERMOTT, OH 45652-3902
(740) 858-6683
Mailing address
546 2ND ST APT 11, PORTSMOUTH, OH 45662-3886
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
APS.004918
OH
Other
Enumeration date
03/25/2024
Last updated
03/25/2024
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