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NPI Code Detail

MEDICARE: KELLI DRISCOLL

MEDICARE: KELLI DRISCOLL
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
12251G0304XGeriatric Physical Therapist

General Provider Information

NPI Number : 1144966367
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLI DRISCOLL
Provider Business Mailing Address
First Line : 927 S RIDGE ST
Second Line :
City : CROWN POINT
State : IN
Zip : 46307-5010
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10700 PARK PL
Second Line :
City : SAINT JOHN
State : IN
Zip : 46373-8666
Country : US
Telephone Number : 219-247-6459
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2022
Last Update Date : 05/10/2022

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Directions to “ KELLI DRISCOLL ” Practice Location

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