| Doctor Name: | MR. ANDREW EDWARD KELLY |
| NPI Number: | 1871593004 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.T. |
| License Number: | 15707 |
| Business Practice Address: | 165 N Redwood Dr San Rafael, CA - 949031969 |
| Business Phone Number: | 4154990278 |
| Business Fax Number: | 4154990297 |
| Mailing Address: | 165 N Redwood Dr, SAN RAFAEL |
| State: | CA |
| Postal Code: | 949031970 |
| Phone Number: | 4154990278 |
| Fax Number: | 4154990297 |
| NPI Enumeration Date: | 07/29/2005 |
| NPI Last Update Date: | 07/11/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 15707 |
| 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 |