Individual
ELLEN BETH KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
5040 SNAPFINGER WOODS DR, SUITE 205, DECATUR, GA 30035-4020
(678) 205-5736
(678) 205-5739
Mailing address
5703 NEWNAN CIR, AUSTELL, GA 30106-3197
(404) 273-5012
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT001002
GA
Other
Enumeration date
07/06/2006
Last updated
07/08/2007
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