Provider Demographics
NPI:1841524774
Name:WHALEN, MARY KELLY (PT)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:KELLY
Last Name:WHALEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5 S CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-4820
Mailing Address - Country:US
Mailing Address - Phone:610-918-0990
Mailing Address - Fax:610-918-3210
Practice Address - Street 1:216 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:ORELAND
Practice Address - State:PA
Practice Address - Zip Code:19075-1230
Practice Address - Country:US
Practice Address - Phone:215-887-0820
Practice Address - Fax:215-887-0689
Is Sole Proprietor?:No
Enumeration Date:2009-09-24
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT002914L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist