Individual
KELLY SELTZER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BAS
Contact information
Practice address
320 MONTEREY CIR, JONESBORO, GA 30236-8242
(404) 399-9077
Mailing address
320 MONTEREY CIR, JONESBORO, GA 30236-8242
(404) 399-9077
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21554587418
—
GA
Enumeration date
09/26/2018
Last updated
09/26/2018
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