Individual
LISA KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
809 HUNTER HWY STE 5, TUNKHANNOCK, PA 18657-8070
(570) 996-2700
(570) 996-2711
Mailing address
15 FRED DR, TUNKHANNOCK, PA 18657-7717
(570) 407-2555
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN004024
PA
Other
Enumeration date
11/21/2023
Last updated
12/29/2023
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