Individual
KELLY J SPRAGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
100 FRANKFORT SQ, COLUMBUS, OH 43206-1058
(614) 738-5079
Mailing address
2174 SAWBURY BLVD, COLUMBUS, OH 43235-1856
(614) 738-5079
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
33-016869
OH
Other
Enumeration date
08/13/2015
Last updated
02/24/2017
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