Kelley, Mark
Kelley, Mark is an sole proprietor health care provider with primary practice located at 394 N Suncoast Blvd Ste 40, Crystal River FL 34429-5466. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as his primary health care specialty. Kelley, Mark can be contacted via phone (352) 795-6225.Contact Information
Primary practice address
394 N Suncoast Blvd Ste 40
Crystal River FL 34429-5466
Phone: (352) 795-6225
Fax: (352) 795-6065
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant | 225200000X | PTA21605 | Florida |
Profile Details
| NPI number | 1598998858 |
|---|---|
| LBN Legal business name | Kelley, Mark |
| Credentials | Physical Therapist Assistant (PTA) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 2nd, 2009 |
| Last updated | Sep 2nd, 2009 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598998858 | NPPES |
| Florida | Other | 106898 | MEDICARE ID |
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