Provider Demographics
NPI:1619269461
Name:KELLY, EMILY K (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:K
Last Name:KELLY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:K
Other - Last Name:MUFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:6612 S WARD ST
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-4855
Mailing Address - Country:US
Mailing Address - Phone:303-409-2133
Mailing Address - Fax:303-409-2233
Practice Address - Street 1:6612 S WARD ST
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-4855
Practice Address - Country:US
Practice Address - Phone:303-409-2133
Practice Address - Fax:303-409-2233
Is Sole Proprietor?:No
Enumeration Date:2011-05-12
Last Update Date:2017-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO111482251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCOAAA1891OtherMEDICARE PTAN