Kelly Jean Detherage PTA

  • NPI 1245543966
According to our database, the NPI number for Kelly Jean Detherage PTA is 1245543966 and activated since 13 years ago. Kelly Jean Detherage PTA is an individual provider who specializes in Physical Therapy Assistant, and the primary practice location is 1201 Holland Lake Drive, Weatherford, TX 76086. You can also contact Kelly Jean Detherage PTA via telephone number is (817) 613-9699. Provider NPI information was last updated on 07/22/2010.

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Overview of Kelly Jean Detherage PTA

  • NPI number: 1598434045
  • Provider type: Individual
  • Gender: Female
  • Active since: 07/22/2010
  • Last updated: 07/22/2010

Primary Scrop of Practice

  • Taxonomy Code: 225200000X
  • Specialty: Physical Therapy Assistant
  • License Number: 2076950
  • License State: TX

Provider Mailing Address

  • Address: 4560 Se International Way
    Ste. 100
    Milwaukie, OR 97222
  • Phone: 971-206-5200
  • Fax: 971-206-5203

Provider Practice Location

  • Address: 1201 Holland Lake Drive
    Weatherford, TX 76086
  • Phone: 817-613-9699
  • Fax: 817-594-9786

Scope of Practice

  • Taxonomy Code: 225200000X
  • Specialty: Physical Therapy Assistant
  • License Number: 2076950
  • License State: TX
  • Switch: Yes

Question & Answers

  • Q: What is the npi number?
  • A: An NPI is a 10-digit numeric identifier. It does not carry information about you, such as the State where you practice, your provider type, or your specialization. Your NPI will not change, even if your name, address, taxonomy, or other information changes.
  • Q: What are health care provider taxonomy codes?
  • A: The Health Care Provider (HCP) Taxonomy Codes Codes define a health care service provider type, classification, and area of specialization.
  • Q: What is the npi number for Kelly Jean Detherage PTA?
  • A: The npi number for Kelly Jean Detherage PTA is 1245543966.
  • Q: What are Kelly Jean Detherage PTA's specialties?
  • A: Kelly Jean Detherage PTA's specialties are Physical Therapy Assistant and different specialities.
  • Q: What is the medical license for Kelly Jean Detherage PTA?
  • A: The medical license number for Kelly Jean Detherage PTA is 2076950 and issued in TX in USA.
  • Q: Where is Kelly Jean Detherage PTA practice location?
  • A: Kelly Jean Detherage PTA is practicing at 1201 Holland Lake Drive, Weatherford, TX 76086.
  • Q: How to contact Kelly Jean Detherage PTA?
  • A: You can contact Kelly Jean Detherage PTA via 817-613-9699.
Medicare Specialty
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