Mack, Kellie

Mack, Kellie is an individual health care provider with primary practice located at 709 Allen Dr , Vidalia GA 30474-6348. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as her primary health care specialty. Mack, Kellie can be contacted via phone (912) 373-2568.

Contact Information

Primary practice address
709 Allen Dr Vidalia GA 30474-6348
Phone: (912) 373-2568
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X

Profile Details

NPI number 1972271765
LBN Legal business name Mack, Kellie
Credentials Athletic Trainer, Certified (ATC)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 6th, 2021
Last updated Sep 6th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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