DERK KELLY

WAUWATOSA, WI
NPI1114272093
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225100000X Physical Therapist
(Licence: WI  12071-24)
Enumeration Date2012-07-17
Last Update Date2012-07-17
Business Address
-- DERK KELLY PT,DPT
6004 W WELLS ST
WAUWATOSA, WI 53213-3244
Phone number: 804-349-5941
Mailing Address
-- DERK KELLY PT,DPT
6004 W WELLS ST
WAUWATOSA, WI 53213-3244
Phone number: 804-349-5941
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