Most Relevant Information
Provider Data
| NPI Number: | 1003275181 |
| Provider Name: | KELLI WILKINS MA ATC |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: | 573 |
Most Important Dates
| Enumeration Date: | 02/17/2016 |
| Last Updated: | 02/17/2016 |
Provider Practice Location
15411 TUCKER ST
BENNINGTON
NE
680071859
Practice Location Phone/Fax
| Phone: | 4022504117 |
| Fax: |
Provider Mailing Location
15411 TUCKER ST
BENNINGTON
NE
680071859
Provider Mailing Phone/Fax
| Phone: | 4022504117 |
| Fax: |