Individual
MR. KENNETH KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BC-HIS
Contact information
Practice address
1754 MADISON ST STE A, CLARKSVILLE, TN 37043-2923
(931) 645-4467
Mailing address
1754 MADISON ST STE A, CLARKSVILLE, TN 37043-2923
(931) 645-4467
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
209
TN
Other
Enumeration date
06/13/2017
Last updated
06/13/2017
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