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1821301961
KENNETH JASON KELLY
COLONIAL HEIGHTS, VA
NPI
1821301961
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: VA 2305206555)
Enumeration Date
2010-07-19
Last Update Date
2020-05-27
Business Address
KENNETH JASON KELLY PT, DPT
300B TEMPLE LAKE DR STE 1
COLONIAL HEIGHTS, VA 23834-2973
Phone number: 804-524-9036
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Mailing Address
KENNETH JASON KELLY PT, DPT
350 NEW FIDELITY CT
GARNER, NC 27529-2665
Phone number: 919-258-2714
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