Individual
MS. KELLY SCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3818 BROCKETT TRL, G, CLARKSTON, GA 30021-1562
(404) 989-6293
Mailing address
3818 BROCKETT TRL, G, CLARKSTON, GA 30021-1562
(404) 989-6293
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
CN0028864031
GA
Other
Enumeration date
07/21/2012
Last updated
07/21/2012
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