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NPI Code Detail

MEDICARE: ALLYSON KELLEY

MEDICARE: ALLYSON KELLEY
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
12251P0200XPediatric Physical Therapist7588CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1649290628
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLYSON KELLEY
Provider Business Mailing Address
First Line : 3090 N ACADEMY BLVD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80917-5310
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3090 N ACADEMY BLVD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80917-5310
Country : US
Telephone Number : 719-574-8300
Fax Number : 719-574-9547
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2006
Last Update Date : 07/10/2007

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Directions to “ ALLYSON KELLEY ” Practice Location

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