Individual
JONATHAN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
736 CAMBRIDGE ST, BRIGHTON, MA 02135-2907
(617) 789-3000
Mailing address
31 HAMPDEN AVE, BURLINGTON, MA 01803-4327
(978) 604-6134
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
1558
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558
—
MA
Enumeration date
06/28/2022
Last updated
06/28/2022
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