Individual
MRS. KIMBERLY A KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
300 RACE ST, WISCONSIN DELLS, WI 53965-1822
(608) 254-2574
Mailing address
300 RACE ST, WISCONSIN DELLS, WI 53965-1822
(608) 254-2574
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5562-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40282100
—
WI
Enumeration date
04/08/2008
Last updated
04/08/2008
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