Individual
KELLY J PAULEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
N2950 STATE ROAD 67, LAKE GENEVA, WI 53147-2655
(262) 245-0535
Mailing address
N2950 STATE ROAD 67, LAKE GENEVA, WI 53147-2655
(262) 245-0535
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5425 024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40316200
—
WI
Enumeration date
06/23/2006
Last updated
07/08/2007
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