Etheridge, Kelley Lyn

Etheridge, Kelley Lyn is an individual health care provider with primary practice located at 52 Woodsfield Ln , Hiram GA 30141-5165. 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. Etheridge, Kelley Lyn can be contacted via phone (404) 218-9051.

Contact Information

Primary practice address
52 Woodsfield Ln Hiram GA 30141-5165
Phone: (404) 218-9051
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 1073660759
LBN Legal business name Etheridge, Kelley Lyn
Credentials Athletic Trainer, Certified (ATC)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 4th, 2007
Last updated Jul 10th, 2007 - about 19 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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