Individual
JILL M KELLY-KETAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
32 BUCK RD, HANOVER, NH 03755-2700
(603) 643-7290
Mailing address
52 SPRING ST, LEBANON, NH 03766-2521
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1120
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
904486749/268724
UNITED HEALTHCARE INSURAN
NH
Enumeration date
02/11/2008
Last updated
02/11/2008
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