Individual
JIMMY KELLY II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
TRS/TXC
Contact information
Practice address
4500 S LANCASTER RD, DALLAS, TX 75216-7167
(214) 857-4228
Mailing address
4500 S LANCASTER RD, DALLAS, TX 75216-7167
(214) 857-4228
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
—
—
Other
Enumeration date
06/22/2021
Last updated
06/22/2021
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