Individual
MR. CHARLES CHRISTOPHER KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T
Contact information
Practice address
124 ARBORGATE CIR, COLUMBIA, SC 29212-2465
(843) 870-8422
Mailing address
124 ARBORGATE CIR, COLUMBIA, SC 29212-2465
(843) 870-8422
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS.6235
SC
Other
Enumeration date
03/01/2010
Last updated
03/01/2010
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