| Doctor Name: | KELLY HALL BOUTCHYARD |
| NPI Number: | 1801030499 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPT |
| License Number: | |
| Business Practice Address: | 5567 N Croatan Hwy Kitty Hawk, NC - 279494090 |
| Business Phone Number: | 2522611556 |
| Business Fax Number: | 2522616161 |
| Mailing Address: | 136 Carolina Ct W, MANTEO |
| State: | NC |
| Postal Code: | 279549545 |
| Phone Number: | 2523382114 |
| Fax Number: | 2523382115 |
| NPI Enumeration Date: | 04/27/2009 |
| NPI Last Update Date: | 05/23/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| 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 |