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Individual

DYLAN L KELLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
4572 TELEPHONE RD STE 903, VENTURA, CA 93003-5663
(805) 654-8127
(805) 654-8149
Mailing address
4572 TELEPHONE RD STE 903, VENTURA, CA 93003-5663
(805) 654-8127
(805) 654-8149

Taxonomy

Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
298744
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
298744
STATE LICENSE
CA
Enumeration date
08/11/2020
Last updated
02/22/2023
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