Individual
ZACHARY ALEC KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-2401
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-1414
Taxonomy
Speciality
Code
Description
License number
State
207YP0228X
Pediatric Otolaryngology Physician
Primary
92046
SC
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/04/2018
Last updated
08/09/2024
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