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Individual

MR. KELLY DEAN WINTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CP, LP

Contact information

Practice address
7675 LANIER VIEW RDG, CUMMING, GA 30041-2162
(770) 844-1909
Mailing address
7675 LANIER VIEW RDG, CUMMING, GA 30041-2162
(770) 844-1909

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
000034
GA
335E00000X
Prosthetic/Orthotic Supplier
Primary

Other

Enumeration date
05/09/2007
Last updated
05/23/2008
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