Individual
BRIAN KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
2040 NORTH WILMONT RD, TUCSON, AZ 85712
(434) 825-3658
Mailing address
2812 MONTVIEW WAY SW, MARIETTA, GA 30060-5145
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT013403
GA
Other
Enumeration date
05/12/2022
Last updated
05/12/2022
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