Individual
MS. KELLY ERIN MIDDENDORF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DI
Contact information
Practice address
3067 MAGNOLIA CT, EDGEWOOD, KY 41017-3371
(859) 341-4077
(859) 341-0573
Mailing address
3067 MAGNOLIA CT, EDGEWOOD, KY 41017-3371
(859) 341-4077
(859) 341-0573
Taxonomy
Speciality
Code
Description
License number
State
2251C2600X
Cardiopulmonary Physical Therapist
Primary
222Q00000X
KY
Other
Enumeration date
04/23/2007
Last updated
07/08/2007
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