Individual
MS. AMANTHA(MANDY) FRANCES KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
8035 ROMINE CT, LAS VEGAS, NV 89149-4755
(702) 812-6910
Mailing address
10597 CASA BIANCA ST, LAS VEGAS, NV 89141-4200
(702) 812-6910
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
014281
NY
174400000X
Specialist
Primary
NVMT2827
NV
Other
Enumeration date
02/26/2010
Last updated
02/26/2010
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