Individual
MS. KELLY DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT ATC
Contact information
Practice address
1134 N ROAD ST, BLDG 7, ELIZABETH CITY, NC 27909-3365
(252) 384-2360
(252) 384-2359
Mailing address
1134 N ROAD ST, BLDG 7, ELIZABETH CITY, NC 27909-3365
(252) 384-2360
(252) 384-2359
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2966
NC
Other
Enumeration date
09/22/2016
Last updated
09/22/2016
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