| Doctor Name: | MRS. CARRIE KELLY |
| NPI Number: | 1124475694 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT, DPT |
| License Number: | 1210949 |
| Business Practice Address: | 12301 Falcon Rd Crandall, TX - 751145211 |
| Business Phone Number: | 2146862957 |
| Business Fax Number: | |
| Mailing Address: | 12301 Falcon Rd, CRANDALL |
| State: | TX |
| Postal Code: | 751145211 |
| Phone Number: | 2146862957 |
| Fax Number: | |
| NPI Enumeration Date: | 05/15/2016 |
| NPI Last Update Date: | 05/15/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251P0200X |
| License Number: | 1210949 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |