Individual
KELLY MARIE WHITLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2474 E JOYCE BLVD STE 2, FAYETTEVILLE, AR 72703-4932
(479) 521-8326
Mailing address
2740 COLLEGE AVE, CONWAY, AR 72034-6141
(501) 329-5459
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4732
AR
Other
Enumeration date
08/28/2019
Last updated
07/20/2021
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