Provider Demographics
NPI:1982697017
Name:ISABELL, KELLY RAE (PTA)
Entity Type:Individual
Prefix:MS
First Name:KELLY
Middle Name:RAE
Last Name:ISABELL
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
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Mailing Address - Street 1:8109 N HICKORY ST
Mailing Address - Street 2:APT 226
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64118
Mailing Address - Country:US
Mailing Address - Phone:816-213-7981
Mailing Address - Fax:816-415-8270
Practice Address - Street 1:2100 SWIFT AVE
Practice Address - Street 2:
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3426
Practice Address - Country:US
Practice Address - Phone:816-474-8877
Practice Address - Fax:816-474-8878
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2005032620225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant