Individual
KELLEY MICHAEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LMT
Contact information
Practice address
134 HIGH ST, IPSWICH, MA 01938-1208
(978) 356-3137
Mailing address
9 PUTNAM RD, IPSWICH, MA 01938-2123
(978) 500-6924
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2634
MA
Other
Enumeration date
08/28/2020
Last updated
08/28/2020
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