Individual
MR. KELLY JAY FERRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1015 CAMPBELL WAY, SEYMOUR, TN 37865-6615
(865) 573-5557
(865) 522-3218
Mailing address
1015 CAMPBELL WAY, SEYMOUR, TN 37865-6615
(865) 573-5557
(865) 522-3218
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3641
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3105588
BCBS PHYSICAL THERAPY
TN
01
—
3651332
MEDICARE ID-TYPE UNSPECIFIED PHYSICAL THERAPY
TN
05
—
3651332
—
TN
01
—
3651552
MEDICARE ID-TYPE UNSPECIFIED PHYSICAL THERAPY GROUP
TN
01
—
650016650
MEDICARE RAILROAD
TN
Enumeration date
05/19/2006
Last updated
02/08/2012
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