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Individual

MR. BRIAN KELLUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MSPT

Contact information

Practice address
6306 SILVER MOON CT, INDIANAPOLIS, IN 46259-8749
(317) 862-6717
Mailing address
6306 SILVER MOON CT, INDIANAPOLIS, IN 46259-8749
(317) 862-6717

Taxonomy

Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
05006047A
IN

Other

Enumeration date
04/19/2007
Last updated
07/08/2007
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