Individual
KENDALL KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
36065 SANTA FE AVE, FORT HOOD, TX 76544-5060
(254) 553-6974
Mailing address
36065 SANTA FE AVE, FORT HOOD, TX 76544-5060
(254) 553-6974
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
760920
TX
Other
Enumeration date
04/05/2023
Last updated
04/05/2023
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