| Doctor Name: | SUSAN S KELLY |
| NPI Number: | 1669566139 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT |
| License Number: | PT23124 |
| Business Practice Address: | 1340 Lake Blvd. Davis, CA - 95616 |
| Business Phone Number: | 5307535338 |
| Business Fax Number: | 5307534609 |
| Mailing Address: | Po Box 255228, SACRAMENTO |
| State: | CA |
| Postal Code: | 95865 |
| Phone Number: | 8004700071 |
| Fax Number: | |
| NPI Enumeration Date: | 10/02/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT23124 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |