Individual
ANDREW KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
13330 BLOOMFIELD AVE STE 101, NORWALK, CA 90650-3259
(562) 484-3860
Mailing address
13330 BLOOMFIELD AVE STE 101, NORWALK, CA 90650-3259
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
294173
CA PT LICENSE
CA
Enumeration date
12/05/2017
Last updated
12/05/2017
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