Provider Demographics
NPI:1669672184
Name:SLOTHOWER, KELLY J (DPT)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:J
Last Name:SLOTHOWER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:910 FOULK RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-3158
Mailing Address - Country:US
Mailing Address - Phone:302-477-1536
Mailing Address - Fax:302-477-1564
Practice Address - Street 1:150 MONUMENT RD STE 110
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1725
Practice Address - Country:US
Practice Address - Phone:484-268-1350
Practice Address - Fax:484-268-1351
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ10002778225100000X
NC106132251S0007X
2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports