Individual
BRIAN P KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
98 CHAPMAN AVE, AUBURN, NY 13021-4632
(315) 258-0650
Mailing address
98 CHAPMAN AVE, AUBURN, NY 13021-4632
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
306735
NY
Other
Enumeration date
06/11/2012
Last updated
06/11/2012
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