Kelly Fountain, M.s., L.p.t., L.l.c.

NPI #1154714384 in Mobile, Alabama

Provider Information

NPI Number: 1154714384
Entity Type: Organization
Organization Name: Kelly Fountain, M.s., L.p.t., L.l.c.
Primary Specialty: Counselor
Enumeration Date: Mar 12, 2015
Last Updated: Mar 12, 2015

Practice Location

Address: 2864 DAUPHIN ST
Address 2: SUITE A
City: Mobile
State: Alabama
ZIP Code: 36606-2479
Phone: (251) 470-7607

Authorized Official

Name: KELLY FOUNTAIN, MS, LPT
Title: OWNER
Phone: (251) 470-7607

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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