Individual
KELLEY AMADASUN IV
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
905 GREEN COVE LN, DALLAS, TX 75232-1639
(214) 374-6722
(214) 376-3909
Mailing address
905 GREEN COVE LN, DALLAS, TX 75232-1639
(214) 374-6722
(214) 376-3909
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
06/12/2006
Last updated
07/08/2007
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