Individual
MS. KELLY L DORTCH
Active
Individual
MS. KELLY L DORTCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1192880
TX
225100000X
Physical Therapist
2305205166
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1192880
STATE LICENSE NUMBER
TX
01
—
2305205166
VA LICENSE
VA
Enumeration date
10/19/2007
Last updated
03/23/2015
Update your record
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