Individual
ALLISON KELLISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10 PARSONAGE RD, SUITE 508, EDISON, NJ 08837-2429
(732) 906-1144
Mailing address
18 RIDGE RD, CLARK, NJ 07066-2916
(732) 382-0318
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40QA00390700
LICENSE#
NJ
Enumeration date
08/29/2006
Last updated
11/24/2007
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