Lively, Kelly A.
Lively, Kelly A. is an sole proprietor health care provider with primary practice located at 1180 Hope St , Bristol RI 02809-1126. 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. Lively, Kelly A. can be contacted via phone (401) 254-1105.Contact Information
Primary practice address
1180 Hope St
Bristol RI 02809-1126
Phone: (401) 254-1105
Fax: (401) 254-1026
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | PT00693 | Rhode Island |
Profile Details
| NPI number | 1417119249 |
|---|---|
| LBN Legal business name | Lively, Kelly A. |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 2nd, 2008 |
| Last updated | Jul 2nd, 2008 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417119249 | NPPES |
| Rhode Island | Other | PT 00693 | STATE LICENSE |
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