Individual
DR. KELLY SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
20 OLD PLEASANT GROVE RD, MT JULIET, TN 37122-3879
(615) 758-3833
Mailing address
20 OLD PLEASANT GROVE RD, MT JULIET, TN 37122-3879
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3326
TN
Other
Enumeration date
07/06/2016
Last updated
07/06/2016
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