Individual
JOSHUA KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.T.
Contact information
Practice address
119 E 4TH ST, TULSA, OK 74103-5002
(918) 382-0200
(918) 382-0218
Mailing address
4812 E 33RD ST, TULSA, OK 74135-2038
(918) 622-4126
(918) 270-2398
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4474
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200034500A
—
OK
05
—
200034500B
—
OK
05
—
200034500C
—
OK
05
—
200034500D
—
OK
05
—
200034500E
—
OK
05
—
200034500F
—
OK
05
—
200034500G
—
OK
05
—
200034500H
—
OK
05
—
200034500I
—
OK
Enumeration date
07/06/2011
Last updated
06/20/2012
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