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Individual
MRS. KELLY JEAN MAIER
Active
Individual
MRS. KELLY JEAN MAIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
15204
NC
225100000X
Physical Therapist
7517
SC
225100000X
Physical Therapist
PT9109
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15204
PT LICENSE
NC
01
—
7517
PT LICENSE
SC
01
—
PT9109
LICENSE
OH
Enumeration date
03/02/2010
Last updated
03/15/2017
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