Individual
ELLEN BROOKE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
7727 MALL RD STE B, FLORENCE, KY 41042-2666
(859) 282-1751
Mailing address
2191 LUMBERJACK DR, HEBRON, KY 41048-7929
(606) 260-0639
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2280DT
KY
Other
Enumeration date
06/28/2022
Last updated
06/28/2022
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