Individual
KELLY O'HARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
155 W HAMPDEN AVE, SUITE A, ENGLEWOOD, CO 80110-2400
(303) 789-0772
Mailing address
3586 S DEPEW ST UNIT 306, LAKEWOOD, CO 80235-2808
(720) 938-4104
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA
LICENSE#
CO
Enumeration date
08/31/2006
Last updated
07/08/2007
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