Individual
RAIGHAN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
313 MACCORKLE AVE SW STE 100, CHARLESTON, WV 25303-1207
(304) 746-3704
Mailing address
1500 GRAND CENTRAL AVE STE 101, VIENNA, WV 26105-1079
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT004861
WV
Other
Enumeration date
06/02/2025
Last updated
06/02/2025
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