Individual
MR. MICHAEL R KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
400 S 43RD ST, RENTON, WA 98055-5714
(425) 690-3650
(425) 690-9650
Mailing address
400 S 43RD ST, RENTON, WA 98055-5714
(425) 690-3650
(425) 690-9650
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT00008940
WA
2251X0800X
Orthopedic Physical Therapist
Primary
PT00008940
WA
Other
Enumeration date
04/20/2007
Last updated
05/09/2023
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