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NPI Code Detail

MEDICARE: KELLY HARDY DPT

MEDICARE: KELLY HARDY DPT
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 Therapist19512MA

General Provider Information

NPI Number : 1205121738
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY HARDY DPT
Provider Business Mailing Address
First Line : 210 COMMERCE WAY
Second Line : SUITE 120
City : PORTSMOUTH
State : NH
Zip : 03801-8200
Country : US
Telephone Number : 207-439-2675
Fax Number : 207-439-4965
Provider Business Practice Location Address
First Line : 3 FERRY ST
Second Line : SUITE F
City : HAVERHILL
State : MA
Zip : 01835-7442
Country : US
Telephone Number : 978-469-9412
Fax Number : 978-469-0693
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2011
Last Update Date : 02/22/2013

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