Individual
MISS KELLY A NOLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
159 W 1ST ST, OSWEGO, NY 13126-2045
(315) 342-9575
Mailing address
232 WYNNFIELD DR, SYRACUSE, NY 13219-2925
(315) 575-4610
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
046274
NY
Other
Enumeration date
09/29/2020
Last updated
09/29/2020
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