Individual
KELLY ANN WITCHLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
202 S GEORGE ST, ROME, NY 13440-6541
(315) 368-4574
Mailing address
7004 YAGER RD, DURHAMVILLE, NY 13054-3151
(315) 368-4574
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
022736
NY
Other
Enumeration date
11/24/2009
Last updated
11/24/2009
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