Provider Demographics
NPI:1235193442
Name:KELLEY, ERIN LYNN (DPT, MSPT, OCS, ATC)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:LYNN
Last Name:KELLEY
Suffix:
Gender:F
Credentials:DPT, MSPT, OCS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2959 ALPINE TER
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45208-3407
Mailing Address - Country:US
Mailing Address - Phone:513-533-9118
Mailing Address - Fax:
Practice Address - Street 1:222 PIEDMONT AVE STE 2200
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-4238
Practice Address - Country:US
Practice Address - Phone:513-621-7777
Practice Address - Fax:513-221-5761
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY004487225100000X
OH11544225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist