Carder Kelly, PT
Specialist in Smithtown, NY. Individual provider (NPI-1).
NPI number1497960751
StatusActive
Last updated in NPPESJul 26, 2009
Details
- NPI
- 1497960751
- Entity type
- Individual (NPI-1)
- Name
- Mr. Carder Kelly
- Credential
- PT
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 11, 2007
- Last updated
- Jul 26, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | 022575-1 | NY | Yes |
Practice location
260 Middle Country RdSmithtown, NY 11787-2982
Phone 631-382-4550
Mailing address
260 Middle Country RdSmithtown, NY 11787-2982
Phone 631-382-4550
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