Individual
KELLY K RYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
35 HOLLY PARK LN, #122, LEXINGTON, VA 24450-3756
(808) 557-0949
Mailing address
35 HOLLY PARK LN, #122, LEXINGTON, VA 24450
(808) 557-0949
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
12344
CO
Other
Enumeration date
08/03/2012
Last updated
08/03/2012
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