Individual
KELLYE BRANCH DONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
1050 N FLOWOOD DR, FLOWOOD, MS 39232-9738
(662) 418-0233
Mailing address
604 ARLINGTON CT, MADISON, MS 39110-7192
(601) 668-3755
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT5368
MS
Other
Enumeration date
10/18/2018
Last updated
10/18/2018
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