Individual
KIANA LANIECE KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2058 GLENN FLS, GROVETOWN, GA 30813-5498
(762) 444-4674
Mailing address
2058 GLENN FLS, GROVETOWN, GA 30813-5498
(762) 444-4674
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/25/2021
Last updated
06/25/2021
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