Provider Demographics
NPI:1316131246
Name:MATHEWS, KELLY LYNN (PT)
Entity type:Individual
Prefix:MS
First Name:KELLY
Middle Name:LYNN
Last Name:MATHEWS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:LYNN
Other - Last Name:MATTHEWS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:13421 OLD MERIDIAN ST
Mailing Address - Street 2:NEW HOPE ORTHOPAEDICS AND SPORTS MEDICINE SUITE 202
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-1427
Mailing Address - Country:US
Mailing Address - Phone:317-815-1700
Mailing Address - Fax:317-770-1727
Practice Address - Street 1:13421 OLD MERIDIAN ST
Practice Address - Street 2:NEW HOPE ORTHOPAEDICS AND SPORTS MEDICINE SUITE 202
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-1427
Practice Address - Country:US
Practice Address - Phone:317-815-1700
Practice Address - Fax:317-770-1727
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05009325A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist