Provider Demographics
NPI:1023206406
Name:KELLEY, BARRY KENT (CPO, CPED)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:KENT
Last Name:KELLEY
Suffix:
Gender:M
Credentials:CPO, CPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 VICTORIA RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4419
Mailing Address - Country:US
Mailing Address - Phone:828-254-6305
Mailing Address - Fax:828-254-6110
Practice Address - Street 1:75 VICTORIA RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4419
Practice Address - Country:US
Practice Address - Phone:828-254-6305
Practice Address - Fax:828-254-6110
Is Sole Proprietor?:No
Enumeration Date:2007-10-10
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist