Individual
MR. TIMOTHY MICHAEL KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1170 EAGLE DR BLDG 150, SAN ANTONIO, TX 78236-5705
(210) 671-9177
Mailing address
1170 EAGLE DR BLDG 150, SAN ANTONIO, TX 78236-5705
(210) 671-9177
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT4991
TX
Other
Enumeration date
03/25/2022
Last updated
05/17/2022
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