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Organization

KELLY CONLEY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. KELLY LEE CONLEY LPN (LICENSED PRACTICAL NURSE)
(740) 250-4235
Entity
Organization

Contact information

Practice address
46 ANDREA DR, WHEELERSBURG, OH 45694-8789
(740) 250-4235
(740) 250-4235
Mailing address
46 ANDREA DR, WHEELERSBURG, OH 45694-8789
(740) 250-4235
(740) 250-4235

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
123463
OH
251J00000X
Nursing Care Agency
Primary
123463
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7402504235
OH
Enumeration date
12/30/2010
Last updated
12/30/2010
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