Individual
KELLEY COULTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
17 LINDEN PL, REAR COURTYARD, RED BANK, NJ 07701-1939
(732) 970-6164
Mailing address
17 LINDEN PL, REAR COURTYARD, RED BANK, NJ 07701-1939
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
HP0183100
NJ
Other
Enumeration date
04/03/2014
Last updated
04/03/2014
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