Derk Kelly, PT,DPT

NPI #1114272093 in Wauwatosa, Wisconsin

Provider Information

NPI Number: 1114272093
Entity Type: Individual
Name: Derk Kelly, PT,DPT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapist
Credential: PT,DPT
Enumeration Date: Jul 17, 2012
Last Updated: Jul 17, 2012

Practice Location

Address: 6004 W WELLS ST
City: Wauwatosa
State: Wisconsin
ZIP Code: 53213-3244
Phone: (804) 349-5941

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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