Individual
KELLIE LEDAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3965 PHELAN BLVD STE 104, BEAUMONT, TX 77707-2253
(832) 693-2213
Mailing address
5595 BONNIE LEE ST, BEAUMONT, TX 77705-6006
(832) 693-2213
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
P8WUN1JA8R
TX
335E00000X
Prosthetic/Orthotic Supplier
Primary
P8WUN1JA8R
TX
Other
Enumeration date
04/17/2024
Last updated
06/19/2025
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