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NPI Code Detail

MEDICARE: MS. ERIN ANNE KELLY MSPT

MEDICARE: MS. ERIN ANNE KELLY MSPT
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 TherapistPT016855PA

General Provider Information

NPI Number : 1194848671
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ERIN ANNE KELLY MSPT
Provider Business Mailing Address
First Line : 39 FULMORE AVE
Second Line :
City : HATBORO
State : PA
Zip : 19040-3428
Country : US
Telephone Number : 215-620-6203
Fax Number :
Provider Business Practice Location Address
First Line : 1104 WELSH RD
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19115-3730
Country : US
Telephone Number : 215-676-9191
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2007
Last Update Date : 03/12/2010

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