Individual
MR. MICHAEL COBB KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1219 CHURCH ST, ZACHARY, LA 70791-2347
(225) 658-7751
(225) 658-7753
Mailing address
1219 CHURCH ST, ZACHARY, LA 70791-2347
(225) 658-7751
(225) 658-7753
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10619
LA
Other
Enumeration date
06/18/2020
Last updated
06/18/2020
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