Individual
MRS. KELLEY WOOD HERNDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
7601 PARKLANE RD, COLUMBIA, SC 29223-6122
(803) 741-9090
(803) 741-7216
Mailing address
7601 PARKLANE RD, COLUMBIA, SC 29223-6122
(803) 741-9090
(803) 741-7216
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2723S
SC
Other
Enumeration date
02/06/2012
Last updated
02/06/2012
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