Henry Albert Kelly Jr

NPI 1023404704 - Health Maintenance Organization - 302R00000X

NPI Details
NPI 1023404704
Enumeration Date 04/09/2015
Last Updated 04/09/2015
Entity Type Healthcare Provider
Active Over 1 year ago
Authorized Information
Name HENRY ALBERT HENRY
Position MHPA, PH.D
Phone (910) 747-5215
Fax
Practice Location
4124 FIRWOOD LN APT L
CHARLOTTE NC, 28209-2724, US
Phone (910) 747-5215
Fax
Business Location
4124 FIRWOOD LN APT L
CHARLOTTE NC, 28209-2724, US
Phone (910) 747-5215
Fax
Toxanomy
Taxonomy Code 302R00000X
License State Tennessee
License Number 1046352
Remove 1023404704 NPI Number
 

According to our database, Henry Albert Kelly Jr NPI is 1023404704, taxonomy code is 302R00000X and license number is 1046352, license state is located at Tennessee. Henry Albert Kelly Jr physically located at 4124 Firwood Ln Apt L, Charlotte NC, 28209-2724. NPI Number 1033115704 has the healthcare provider type.

Sponsored links

1023404704 NPI number is provided on an as is basis without warranty of any kind. 1023404704 is maintained by the National Plan & Provider Enumeration System. The contents of Henry Albert Kelly Jr are for informational purposes only.