Individual
SHERRY KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
263 LIVINGSTON ST, SHADY SPRING, WV 25918-8573
(304) 894-5566
Mailing address
263 LIVINGSTON ST, SHADY SPRING, WV 25918-8573
(304) 894-5566
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
02/19/2021
Last updated
02/19/2021
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