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NPI Code Detail

MEDICARE: MATTHEW ROBERT KELLY DPT

MEDICARE:   MATTHEW ROBERT KELLY  DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT020074OH

General Provider Information

NPI Number : 1790466217
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW ROBERT KELLY DPT
Provider Business Mailing Address
First Line : 340 POLARIS PKWY
Second Line :
City : WESTERVILLE
State : OH
Zip : 43082-7971
Country : US
Telephone Number : 614-545-7900
Fax Number : 614-545-7901
Provider Business Practice Location Address
First Line : 4611 TRUEMAN BLVD STE B
Second Line :
City : HILLIARD
State : OH
Zip : 43026-2644
Country : US
Telephone Number : 614-340-0683
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2023
Last Update Date : 01/10/2025

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Directions to “ MATTHEW ROBERT KELLY DPT” Practice Location

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