Individual
MR. JOHN D KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPO, CFO
Contact information
Practice address
1110 W SHORE DR, SUITE 400D, RICHARDSON, TX 75080-4054
(972) 470-0300
(972) 470-0301
Mailing address
1110 W SHORE DR, SUITE 400D, RICHARDSON, TX 75080-4054
(972) 470-0300
(972) 470-0301
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
1245
TX
224P00000X
Prosthetist
Primary
1245
TX
Other
Enumeration date
05/30/2007
Last updated
03/15/2012
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