Organization
SPORTPRO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW KELLING PT (PHYSICAL THERAPIST)
(815) 546-8865
Entity
Organization
Contact information
Practice address
781 FAIRGROUNDS RD, MOUNT VERNON, OH 43050-1165
(740) 263-7997
(740) 326-4743
Mailing address
781 FAIRGROUNDS RD, MOUNT VERNON, OH 43050-1165
(740) 263-7997
(740) 326-4743
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT013341
OH
Other
Enumeration date
12/03/2015
Last updated
10/28/2019
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