Individual
MS. KELLEY B. SOUTHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
639 E MAIN ST, SUITE B102, HENDERSONVILLE, TN 37075-2646
(615) 826-7113
(615) 826-7139
Mailing address
639 E MAIN ST, SUITE B102, HENDERSONVILLE, TN 37075-2646
(615) 826-7113
(615) 826-7139
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0000001692
TN
Other
Enumeration date
07/26/2006
Last updated
07/08/2007
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