Individual
MS. KELLEY ELIZABETH FARWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSED, ATC, CSCS
Contact information
Practice address
8614 SYCAMORE GLEN LN, ODENTON, MD 21113-2297
(774) 239-6398
Mailing address
8614 SYCAMORE GLEN LN, ODENTON, MD 21113-2297
(774) 239-6398
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
0126001666
VA
2255A2300X
Athletic Trainer
Primary
A0000618
MD
Other
Enumeration date
10/09/2013
Last updated
08/04/2014
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