Individual
MR. WILLIAM FREDERICK KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
12266 DEPAUL DR., SUITE 115, BRIDGETON, MO 63044
(314) 209-7700
(314) 209-7705
Mailing address
12266 DEPAUL DR., SUITE 115, BRIDGETON, MO 63044
(314) 209-7700
(314) 209-7705
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2001013123
MO
Other
Enumeration date
09/10/2010
Last updated
09/10/2010
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