| Provider / Organization | NPI | Date Certified |
|---|---|---|
| LATRECE D KELLY | 1427784461 | 2022-07-30 |
Latrece D Kelly is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1427784461. Registration indicates Latrece D Kelly is a provider of services with a specialization in Respiratory, Developmental, Rehabilitative and Restorative Service Providers, Massage Therapist (Massage Therapist, ) (Massage Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers)
| Entity Type | Individual |
| Provider Name | Latrece D Kelly |
| Practice Office Address | 3175 PATRICK HENRY DR NW APT F CONCORD, NC US |
| Practice Office Telephone | 7042323261 |
| Mailing Address | 3175 PATRICK HENRY DR NW APT F CONCORD, NC 280276885 US |
| Business Telephone | 7042323261 |
| Code | Practice | License No State |
|---|---|---|
| 225700000X PRIMARY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Massage Therapist Massage Therapist Massage Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers | 17512
NC |