Individual
MIKAYLA NICOLE KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
515 MOE RD, CLIFTON PARK, NY 12065-3821
(518) 280-4294
Mailing address
32 COACHMAN DR, BALLSTON SPA, NY 12020-2710
(518) 225-5031
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
P141979
NY
Other
Enumeration date
05/19/2026
Last updated
05/19/2026
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