Individual
TIMOTHY MICHAEL KELLY, JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPT
Contact information
Practice address
655 BROAD ST, PROVIDENCE, RI 02907-1444
(401) 521-2214
(401) 861-4047
Mailing address
143 SPOFFORD AVE, WARWICK, RI 02888-1816
(401) 270-6033
(401) 861-4047
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1484
RI
Other
Enumeration date
06/19/2007
Last updated
07/08/2007
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