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NPI 1730458613

NPI 1730458613 : KELLY MCCORD STERLING BSW : MORGANTON, NC

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General NPI Number Information
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    NPI Number           |    1730458613
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    Entity Type          |    Individual 
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    Provider Name        |    KELLY MCCORD STERLING BSW
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    12/21/2011
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    Last Update Date     |    01/05/2012
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Provider Practice Location Address
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    Address Line         |    202 PATTERSON ST 
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    City                 |    MORGANTON
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    State                |    NC
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    Zip                  |    28655-3332
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    Country              |    US
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    Telephone            |    828-438-6218
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    207 WILLOWBROOK DR 
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    City                 |    MORGANTON
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    State                |    NC
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    Zip                  |    28655-4038
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    Country              |    US
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    Telephone            |    828-390-1130
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    104100000X
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    Taxonomy Name        |    Social Worker
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    License Number       |    
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    License Number State |    
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