Individual
DAKOTA KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT, CSCS
Contact information
Practice address
555 BRIDGEPORT AVE STE 1, SHELTON, CT 06484-4731
(203) 922-1773
(203) 924-2334
Mailing address
1931 BLACK ROCK TPKE, FAIRFIELD, CT 06825-3506
(203) 384-8681
(203) 384-0722
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12809
CT
Other
Enumeration date
08/19/2020
Last updated
08/19/2020
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