Individual
LISA KELLY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
8101 HINSON FARM RD, SUITE 108, ALEXANDRIA, VA 22306-3403
(703) 664-7660
(703) 664-7663
Mailing address
9900 MAIN ST, SUITE 200A, FAIRFAX, VA 22031-3907
(703) 279-4394
(703) 279-4214
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305202363
VA
Other
Enumeration date
02/06/2006
Last updated
07/08/2007
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