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Individual
TIMOTHY P KELLY
Active
Individual
TIMOTHY P KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT000431
PA
2251E1200X
Ergonomics Physical Therapist
—
—
2251G0304X
Geriatric Physical Therapist
—
—
2251P0200X
Pediatric Physical Therapist
—
—
2251S0007X
Sports Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0202760
HEALTH ASSURANCE
—
01
—
03022001
CAPITAL BLUE CROSS
—
01
—
072236
FIRST PRIORITY HEALTH
—
01
—
102808
HIGHMARK BLUE SHIELD
—
01
—
11228087
CAQH
—
01
—
2106682
AETNA HMO
—
01
—
43037000
INDEPENDENCE BLUE CROSS
—
01
—
5039607
AETNA PPO
—
Enumeration date
09/30/2005
Last updated
07/19/2007
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