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Individual
MARY KELLY
Active
Individual
MARY KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT003228L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
072237
FIRST PRIORITY HEALTH
PA
05
—
07649810
—
PA
01
—
2485028
AETNA HMO
PA
01
—
7313174
AETNA PPO/POS
PA
01
—
KE563880
PA BLUE SHIELD
PA
Enumeration date
02/21/2006
Last updated
07/13/2026
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