Individual
MRS. KELLY GOOD BAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
3001 HUNGARY SPRING RD, SUITE D, RICHMOND, VA 23228-2428
(804) 756-8490
Mailing address
8905 ELI PL, GLEN ALLEN, VA 23060-6399
(804) 935-7557
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305005986
VA
Other
Enumeration date
08/10/2006
Last updated
07/08/2007
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