Individual
MR. BRIAN N KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2170 SOUTH AVE, SOUTH LAKE TAHOE, CA 96150-7026
(530) 543-5896
(530) 544-6512
Mailing address
PO BOX 9578, SOUTH LAKE TAHOE, CA 96158-9578
(530) 543-5896
(530) 544-6512
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2264
NV
225100000X
Physical Therapist
Primary
34365
CA
Other
Enumeration date
01/25/2007
Last updated
03/21/2018
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