Individual
LATRECE D KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3175 PATRICK HENRY DR NW APT F, CONCORD, NC 28027-6885
(704) 232-3261
Mailing address
3175 PATRICK HENRY DR NW APT F, CONCORD, NC 28027-6885
(704) 232-3261
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
17512
NC
Other
Enumeration date
07/30/2022
Last updated
07/30/2022
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