Individual
KELLY J ANTHONY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4486 ORLANDO AVE, BROOKSVILLE, FL 34604-8017
(135) 229-3612
Mailing address
4486 ORLANDO AVE, BROOKSVILLE, FL 34604-8017
(135) 229-3612
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
239688
FL
Other
Enumeration date
10/23/2023
Last updated
10/23/2023
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