Individual
JOHN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1088 LONDON LINKS DR, FOREST, VA 24551-4662
(574) 647-7477
Mailing address
1088 LONDON LINKS DR, FOREST, VA 24551-4662
(434) 534-6868
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101266447
VA
Other
Enumeration date
06/08/2016
Last updated
07/18/2019
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