Provider Demographics
NPI:1205590064
Name:HOBBS, KELLY L (DPT)
Entity type:Individual
Prefix:DR
First Name:KELLY
Middle Name:L
Last Name:HOBBS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2433 DEERMIST WAY
Mailing Address - Street 2:
Mailing Address - City:FUQUAY-VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526
Mailing Address - Country:US
Mailing Address - Phone:919-244-6202
Mailing Address - Fax:
Practice Address - Street 1:2433 DEERMIST WAY
Practice Address - Street 2:
Practice Address - City:FUQUAY-VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-2752
Practice Address - Country:US
Practice Address - Phone:919-244-6202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-27
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP11996225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist