Provider Demographics
NPI:1639870728
Name:M KELLEY, ZORRYA
Entity Type:Individual
Prefix:
First Name:ZORRYA
Middle Name:
Last Name:M KELLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 WEEPING WILLOW RD
Mailing Address - Street 2:
Mailing Address - City:ABBEVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36310-2731
Mailing Address - Country:US
Mailing Address - Phone:334-441-8361
Mailing Address - Fax:
Practice Address - Street 1:121 WEEPING WILLOW RD
Practice Address - Street 2:
Practice Address - City:ABBEVILLE
Practice Address - State:AL
Practice Address - Zip Code:36310-2731
Practice Address - Country:US
Practice Address - Phone:334-441-8361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer