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Individual

ANDREW T KELLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ATC, NASM-CPT

Contact information

Practice address
254 MONROE DR, STANARDSVILLE, VA 22973-2852
(434) 939-9004
Mailing address
14649 SPOTSWOOD TRL, RUCKERSVILLE, VA 22968-3076
(757) 753-7453

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126000858
VA

Other

Enumeration date
04/23/2021
Last updated
04/23/2021
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