KELLY DETHERAGE, PTA
Physical Therapy Assistant
Active
Individual
NPI: 1245543966
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Physical Therapy Assistant | 225200000X | Yes | 2076950 (TX) |
Frequently Asked Questions
NPI 1245543966 is the National Provider Identifier for KELLY DETHERAGE, PTA, a Physical Therapy Assistant provider located in Weatherford, TX. This NPI was enumerated on July 22, 2010.
KELLY DETHERAGE, PTA practices at 1201 HOLLAND LAKE DRIVE, Weatherford, TX 76086.
Quick Facts
- NPI
- 1245543966
- Type
- Individual
- Enumerated
- Jul 22, 2010
- Last Updated
- Jul 22, 2010
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