Individual
WILLIAM AYERS KELLY IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1520 HURST ST, FORT BRAGG, NC 28308
(910) 394-1698
Mailing address
1520 HURST ST, FORT BRAGG, NC 28308
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT5181
TX
Other
Enumeration date
08/05/2019
Last updated
08/05/2019
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