Individual
MRS. KELLY L KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
309 HIGHWAY 641 N, CAMDEN, TN 38320-3011
(731) 584-1722
(731) 584-1733
Mailing address
309 HIGHWAY 641 N, CAMDEN, TN 38320-3011
(731) 584-1722
(731) 584-1733
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT0000007078
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0446685
—
TN
01
—
4117317
BCBS PROVIDER NUMBER
TN
Enumeration date
07/10/2006
Last updated
08/12/2014
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