Domeyer, Kelly L.

Domeyer, Kelly L. is an individual health care provider with primary practice located at 3270 Liberty Rd. S. , Salem OR 97302. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Domeyer, Kelly L. can be contacted via phone (503) 371-0779.

Contact Information

Primary practice address
3270 Liberty Rd. S. Salem OR 97302
Phone: (503) 371-0779
Fax: (503) 371-0886
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 1342 Oregon

Profile Details

NPI number 1487638276
LBN Legal business name Domeyer, Kelly L.
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 5th, 2005
Last updated Aug 5th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487638276 NPPES
Oregon MEDICAID 023002

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