Provider Demographics
NPI:1477848950
Name:MOLETRESS, KELLY (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:
Last Name:MOLETRESS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1570 EGYPT RD STE 120
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-1179
Mailing Address - Country:US
Mailing Address - Phone:610-676-0411
Mailing Address - Fax:610-676-0412
Practice Address - Street 1:1570 EGYPT RD STE 120
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-1179
Practice Address - Country:US
Practice Address - Phone:610-676-0411
Practice Address - Fax:610-676-0412
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-13
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADAPT002801225100000X
PAPT0209512251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist