Individual
BOBBIE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3300 STADIUM DR APT 815, PHENIX CITY, AL 36867-8005
(334) 540-9589
Mailing address
3300 STADIUM DR APT 815, PHENIX CITY, AL 36867-8005
(334) 540-9589
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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