Individual
ALICE M KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
215 E MAIN ST, PROVIDENCE, KY 42450-1261
(270) 667-7017
Mailing address
215 E MAIN ST, PROVIDENCE, KY 42450-1261
(270) 667-7017
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
0164
KY
Other
Enumeration date
06/18/2010
Last updated
05/04/2011
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