Individual
KELLEY N JOHANNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2400 WINCHESTER PL STE 102B, SPARTANBURG, SC 29301-1518
(864) 574-7282
(864) 574-7664
Mailing address
139 DEWFIELD LN, BOILING SPRINGS, SC 29316-6167
(704) 785-5152
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
10792
NC
2251P0200X
Pediatric Physical Therapist
Primary
6818
SC
2251P0200X
Pediatric Physical Therapist
—
—
Other
Enumeration date
01/15/2007
Last updated
12/26/2019
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