Organization
LEGACY BEACH THERAPIES LLC
Active
Organization
LEGACY BEACH THERAPIES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOEL THOMAS KELLEY DPT (OWNER/PHYSICAL THERAPIST)
(254) 493-0648
Entity
Organization
Contact information
Practice address
202 N MAIN ST, NOLANVILLE, TX 76559-4349
(254) 624-6786
Mailing address
8631 CEDAR CREEK RD, TEMPLE, TX 76504-6144
(254) 493-0648
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
Other
Enumeration date
10/28/2022
Last updated
05/11/2023
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