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Lisa Kelly, PT,CERTMDT,COMT
Specialist in Philadelphia, Pennsylvania
NPI 1134120116

Lisa Kelly is a Specialist based in Glen Mills, PA. Lisa Kelly practices in Philadelphia, PA and has the professional credentials of PT,CERTMDT,COMT. The NPI Number for Lisa Kelly is 1134120116 and holds a License No. PT009484-L (Pennsylvania).

The current practice location address for Lisa Kelly is 420 Bainbridge St, Philadelphia, PA and can be reached out via phone at 215-629-1270 and via fax at 215-629-5531.

Location: 420 Bainbridge St, Philadelphia, PA, 19342-1436
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1134120116
Provider Name
Lisa Kelly
Credential
PT,CERTMDT,COMT
Provider Entity Type
Individual
Gender
Female
Address
420 Bainbridge St, Philadelphia, PA, 19342-1436
Phone Number
215-629-1270
Fax Number
215-629-5531
Provider Enumeration Date
08/02/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
PT009484-L 01 PA PT LICENSE NUMBER
institution
Provider Business Practice Location Address Details
Address
420 Bainbridge St
City
Philadelphia
State
Pennsylvania
Zip
19147-1568
Phone Number
215-629-1270
Fax Number
215-629-5531
person
Provider Business Mailing Address Details
Address
420 Bainbridge St
City
Philadelphia
State
Pennsylvania
Zip
19147-1568
Phone Number
215-629-1270
Fax Number
215-629-5531
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
PT009484-L (Pennsylvania)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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