Individual
KELLY BOOHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
211 HARKLEROAD LN, BRISTOL, TN 37620-3417
(423) 845-0269
Mailing address
211 HARKLEROAD LN, BRISTOL, TN 37620-3417
(423) 845-0269
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0000140891
TN
Other
Enumeration date
06/20/2014
Last updated
06/20/2014
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