Doctor Name: | MR. PAUL ALEXANDER KELLY |
NPI Number: | 1275798811 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | L.M.T. |
License Number: | MA 45576 |
Business Practice Address: | 4342 E Tradewinds Ave Lauderdale By The Sea, FL - 333085044 |
Business Phone Number: | 9544913103 |
Business Fax Number: | 9544913105 |
Mailing Address: | 4342 E Tradewinds Ave, LAUDERDALE BY THE SEA |
State: | FL |
Postal Code: | 333085044 |
Phone Number: | 9544913103 |
Fax Number: | 9544913105 |
NPI Enumeration Date: | 07/23/2008 |
NPI Last Update Date: | 04/06/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MA 45576 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |