Provider Demographics
NPI:1962462473
Name:KOVER, KELLY SCOTT (MPT, OCS)
Entity Type:Individual
Prefix:MR
First Name:KELLY
Middle Name:SCOTT
Last Name:KOVER
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Gender:M
Credentials:MPT, OCS
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Other - First Name:
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Mailing Address - Street 1:3115 ROUTE 38
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-9752
Mailing Address - Country:US
Mailing Address - Phone:856-273-8080
Mailing Address - Fax:856-273-0633
Practice Address - Street 1:3115 ROUTE 38
Practice Address - Street 2:SUITE 300
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-9752
Practice Address - Country:US
Practice Address - Phone:856-273-8080
Practice Address - Fax:856-273-0633
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJQA0068732251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic