Individual
GINGER RAE KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1016 FLETCHER ST, WILKESBORO, NC 28697-9472
(336) 667-9261
Mailing address
221 BOUNDARY ST, NEWTON, NC 28658-2755
(828) 217-8440
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A1838
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A1838
PTA
NC
Enumeration date
06/30/2021
Last updated
06/30/2021
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