Individual
ZACHARY T KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
129 N WASHINGTON ST, SUMTER, SC 29150-4949
(803) 774-9000
Mailing address
1925 ADIRONDACK CT, SUMTER, SC 29153-8313
(803) 420-6576
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
225946
SC
Other
Enumeration date
12/05/2018
Last updated
12/05/2018
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