Provider Demographics
NPI:1750500336
Name:KEY, KELLY (PT)
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:
Last Name:KEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 MID-CONTINENT PLAZA
Mailing Address - Street 2:SUITE 185
Mailing Address - City:WEST MEMPHIS
Mailing Address - State:AR
Mailing Address - Zip Code:72301-1700
Mailing Address - Country:US
Mailing Address - Phone:870-732-2828
Mailing Address - Fax:870-732-1727
Practice Address - Street 1:310 MID-CONTINENT PLAZA
Practice Address - Street 2:SUITE 185
Practice Address - City:WEST MEMPHIS
Practice Address - State:AR
Practice Address - Zip Code:72301-1700
Practice Address - Country:US
Practice Address - Phone:870-732-2828
Practice Address - Fax:870-732-1727
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1151110225100000X
ARPT2548225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1151110OtherPT