Individual
BRIANNE J KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4020 COLUMBUS AVE, ANDERSON, IN 46013-5010
(765) 641-7605
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05010831A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01228588
MEDICARE RAILROAD
IN
Enumeration date
07/20/2012
Last updated
10/31/2017
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