Individual
MR. JAMES GERARD KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
120 LOPERWOOD LN, LAGRANGE, OH 44050-9756
(440) 506-1661
Mailing address
120 LOPERWOOD LN, LAGRANGE, OH 44050-9756
(440) 506-1661
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
119519
OH
Other
Enumeration date
08/06/2007
Last updated
08/06/2007
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