Laurel Kelley, OD
Optometrist in Memphis, TN. Individual provider (NPI-1).
NPI number1396242533
StatusActive
Last updated in NPPESOct 5, 2022
Details
- NPI
- 1396242533
- Entity type
- Individual (NPI-1)
- Name
- Laurel Kelley
- Credential
- OD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 12, 2018
- Certification date
- Oct 5, 2022
- Last updated
- Oct 5, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 3547 | TN | Yes |
| 152W00000X | Optometrist | 046011193 | IL |
Practice location
1245 Madison AveMemphis, TN 38104-2211
Phone 901-722-3250 · Fax 901-722-3388
Mailing address
1245 Madison AveMemphis, TN 38104-2211
Phone 901-722-3250 · Fax 901-722-3388
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