Individual
KELSEY DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
491 SOUTHERN HILLS DR, WETUMPKA, AL 36093-2989
(334) 391-2730
Mailing address
491 SOUTHERN HILLS DR, WETUMPKA, AL 36093-2989
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/30/2014
Last updated
10/30/2014
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