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Individual
TIMOTHY P KELLY
Active
Individual
TIMOTHY P KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00002812
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT00002812
LICENSE
WA
Enumeration date
01/09/2007
Last updated
07/08/2007
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