Provider Demographics
NPI:1922422658
Name:SOLTIS, KELLIE LYNN (DPT)
Entity Type:Individual
Prefix:
First Name:KELLIE
Middle Name:LYNN
Last Name:SOLTIS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KELLIE
Other - Middle Name:LYNN
Other - Last Name:REESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5300 DERRY ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-3576
Mailing Address - Country:US
Mailing Address - Phone:717-839-2110
Mailing Address - Fax:717-565-1934
Practice Address - Street 1:103 W MAPLE ST
Practice Address - Street 2:
Practice Address - City:PHILIPSBURG
Practice Address - State:PA
Practice Address - Zip Code:16866-2200
Practice Address - Country:US
Practice Address - Phone:814-342-8304
Practice Address - Fax:814-342-8305
Is Sole Proprietor?:No
Enumeration Date:2014-02-18
Last Update Date:2015-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT023451225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist