Kelly, Andrew Edward

Kelly, Andrew Edward is an individual health care provider with primary practice located at 165 N Redwood Dr , San Rafael CA 94903-1969. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Kelly, Andrew Edward can be contacted via phone (415) 499-0278.

Contact Information

Primary practice address
165 N Redwood Dr San Rafael CA 94903-1969
Phone: (415) 499-0278
Fax: (415) 499-0297
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 15707 California

Profile Details

NPI number 1871593004
LBN Legal business name Kelly, Andrew Edward
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 29th, 2005
Last updated Jul 11th, 2007 - about 17 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 1871593004 NPPES
California Other OPT15707 BLUE SHIELD IND PROV NO
California Other ZZZ64636Z BLUE SHIELD IND PROV NO

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