Individual
THOMAS B KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5905 SEVERIN DR, LA MESA, CA 91942-3806
(619) 589-2606
(619) 464-0900
Mailing address
5905 SEVERIN DR, LA MESA, CA 91942-3806
(619) 589-2606
(619) 464-0900
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA5569
CA
Other
Enumeration date
02/03/2017
Last updated
02/03/2017
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