NPI 1851052005

Anthony Kellam

Practitioner Prevention Professional Norfolk, VA

Practice location

Address: 407 W Little Creek Rd, Norfolk, VA 23505-2301
Phone: (757) 377-6754

Registered specialties

Prevention Professional Primary

Other Service Providers Taxonomy 405300000X Licence A60616220 (VA)

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Registry record

NPI: 1851052005
Entity type: Individual
Sex (as registered): Male
NPI issued: 9 Jan 2022
Record last updated: 9 Jan 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.