Individual
KELLY E BAILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSA
Contact information
Practice address
3636 HIGH ST, PORTSMOUTH, VA 23707-3236
(757) 398-2346
Mailing address
1305 MILL RUN CT, SUFFOLK, VA 23434-2323
(757) 620-7960
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
0136000200
VA
Other
Enumeration date
08/30/2023
Last updated
08/30/2023
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