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General NPI Number Information
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NPI Number | 1639007404
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Entity Type | Individual
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Provider Name | KELLY SHEA PT, DPT, CSRS
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Gender | Female
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Dates
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Enumeration Date | 05/12/2026
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Last Update Date | 05/12/2026
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Provider Practice Location Address
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Address Line | 1390 S POTOMAC ST STE 114
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City | AURORA
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State | CO
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Zip | 80012-4529
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Country | US
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Telephone | 303-745-6717
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Fax |
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Provider Business Mailing Address
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Address Line | 17 MESSIG RD
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City | CLINTON
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State | NJ
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Zip | 08809-1241
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Country | US
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Telephone | 908-752-2463
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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 | 2251N0400X
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Taxonomy Name | Neurology Physical Therapist
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License Number | 40QA02222400
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License Number State | NJ
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