Individual
MR. KELLY JAY FERRIS
Active
Individual
MR. KELLY JAY FERRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
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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