MEDICARE: MRS. ERIN LYNN KELLEY DPT, MSPT, OCS, ATC

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
1	225100000X	Physical Therapist	004487	KY
2	225100000X	Physical Therapist	11544	OH

General Provider Information

NPI Number	:	1235193442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ERIN LYNN KELLEY DPT, MSPT, OCS, ATC

Provider Business Mailing Address
First Line	:	2959 ALPINE TER
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45208-3407
Country	:	US
Telephone Number	:	513-533-9118
Fax Number	:

Provider Business Practice Location Address
First Line	:	222 PIEDMONT AVE STE 2200
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45219-4238
Country	:	US
Telephone Number	:	513-621-7777
Fax Number	:	513-221-5761

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2006
Last Update Date	:	11/20/2014

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