Individual
SHAUNA KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LAT, ATC
Contact information
Practice address
255 WINTER ST UNIT 307, WALTHAM, MA 02451-8748
(617) 543-3194
Mailing address
255 WINTER ST UNIT 307, WALTHAM, MA 02451-8748
(617) 543-3194
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2236
MA
Other
Enumeration date
04/29/2014
Last updated
05/04/2023
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