Individual
MR. MATTHEW KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
340 ROUTE 9, BAYVILLE, NJ 08721-1255
(732) 237-7100
Mailing address
1005 14TH AVE, BELMAR, NJ 07719-2808
(908) 601-1125
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
40QB00269200
NJ
Other
Enumeration date
01/11/2010
Last updated
10/18/2011
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