Individual
MR. BRIAN MICHAEL KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
8228 BRENTWOOD INDUSTRIAL DR, SAINT LOUIS, MO 63144-2815
(314) 781-0679
Mailing address
600 OAKMONT LN, STE 600C, WESTMONT, IL 60559-5548
(630) 575-1980
(630) 928-5080
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070.018364
IL
225100000X
Physical Therapist
Primary
2001012048
MO
Other
Enumeration date
08/30/2006
Last updated
07/07/2020
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