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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

BENJAMIN KENNETH KELLY, LAT, ATC, ITAT

Active Sole Proprietor

BENJAMIN KENNETH KELLY, LAT, ATC, ITAT is a Athletic Trainer healthcare provider located in ACCIDENT, Maryland. NPI 1912570862 is currently active in the NPPES registry. Verify at CMS.

Athletic Trainer · ACCIDENT, MD

Registration Details

NPI Number
1912570862
Provider Type
Individual
Gender
Male
NPI Issued
Jul 19, 2021 (5.0510775432296 yrs)
Last Updated
May 30, 2024
Licenses
AT001691 (WV)
A0000671 (MD)
Sole Proprietor
Yes

Practice Information

Address
86 PRIDE PKWY
ACCIDENT, MD, 215202006
Browse MD providers · Browse ZIP 21520
Phone
3017468668
Primary Specialty
Athletic Trainer
2255A2300X
Additional Specialty
Athletic Trainer

Other Athletic Trainer Providers in ACCIDENT, MD

Name Credential NPI
MS. TERRY J STOUGH ATC 1669773131
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.