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General NPI Number Information
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NPI Number | 1194676056
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Entity Type | Individual
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Provider Name | BRANDON CHRISTOPHER KELLEY DPT PT
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Gender | Male
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Dates
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Enumeration Date | 02/06/2026
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Last Update Date | 02/06/2026
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Provider Practice Location Address
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Address Line | 248 COUNTRY CLUB PKWY
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City | SPRING CREEK
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State | NV
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Zip | 89815-5830
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Country | US
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Telephone | 177-529-6844
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Fax |
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Provider Business Mailing Address
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Address Line | 140 ELMWOOD DR
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City | WILKES BARRE
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State | PA
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Zip | 18702-7227
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Country | US
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Telephone |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT033991
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License Number State | PA
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