Individual
KELLI LEANN HARLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
296 MARVIN HANCOCK DR, JASPER, TX 75951-3479
(409) 384-7041
(409) 384-7064
Mailing address
296 MARVIN HANCOCK DR, JASPER, TX 75951-3479
(409) 384-7041
(409) 384-7064
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2071567
TX
Other
Enumeration date
09/01/2011
Last updated
09/01/2011
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