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NPI Code Detail

MEDICARE: STEPHANIE CARTER KELLEY PT, MS, PHD, OCS

MEDICARE: STEPHANIE CARTER KELLEY PT, MS, PHD, OCS
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 Therapist5369OH

General Provider Information

NPI Number : 1952634271
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE CARTER KELLEY PT, MS, PHD, OCS
Provider Business Mailing Address
First Line : 7710 OLENTANGY RIVER ROAD
Second Line :
City : COLUMBUS
State : OH
Zip : 43235
Country : US
Telephone Number : 614-841-3900
Fax Number : 614-841-3930
Provider Business Practice Location Address
First Line : 7710 OLENTANGY RIVER ROAD
Second Line :
City : COLUMBUS
State : OH
Zip : 43235
Country : US
Telephone Number : 614-841-3900
Fax Number : 614-841-3930
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2009
Last Update Date : 10/31/2012

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