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General NPI Number Information
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NPI Number | 1962286708
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Entity Type | Organization
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Legal Business Name | KELOS PHYSICAL THERAPY
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Dates
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Enumeration Date | 08/22/2023
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Last Update Date | 10/19/2023
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Provider Practice Location Address
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Address Line | 2418 E YORK ST
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City | PHILADELPHIA
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State | PA
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Zip | 19125-3006
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Country | US
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Telephone | 267-459-3191
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Fax |
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Provider Business Mailing Address
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Address Line | 2021 E DAUPHIN ST
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City | PHILADELPHIA
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State | PA
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Zip | 19125-1517
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Country | US
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Telephone | 267-459-3191
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Fax |
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Authorized Official
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Title or Position | OWNER / PHYSICAL THERAPIST
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Name | DR. SAMUEL MARTIN KELOKATES
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Credential | DPT
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Telephone | 267-459-3191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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