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Individual

KELLY RICHARD HARROLD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPT

Contact information

Practice address
120 E 5TH ST, TIPTON, IA 52772-1731
(563) 886-3421
(563) 886-2083
Mailing address
2401 TOWNCREST DR, IOWA CITY, IA 52240-6631
(319) 354-2429
(319) 354-6100

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
004537
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0665463
IA
Enumeration date
06/07/2010
Last updated
06/07/2010
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