Individual
KELLY MOYES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
35 MYRTLE AVE, KEYPORT, NJ 07735-1710
(973) 895-3658
Mailing address
35 MYRTLE AVE, KEYPORT, NJ 07735-1710
(973) 895-3658
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
40QB00290900
NJ
Other
Enumeration date
02/29/2016
Last updated
02/29/2016
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