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Individual

MR. KYLE KELLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
12550 S RIDGELAND AVE, PALOS HEIGHTS, IL 60463-1859
(708) 597-9300
Mailing address
19647 THERESE LN, MOKENA, IL 60448-1752
(847) 909-7803

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160007018
IL

Other

Enumeration date
06/19/2015
Last updated
06/19/2015
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