KELLY JEAN DETHERAGE PTA
NPI 1245543966
Physical Therapy Assistant in Weatherford, TX
About Kelly Jean Detherage Pta NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELLY JEAN DETHERAGE PTA (NPI 1245543966) is an individual physical therapy assistant in Weatherford, Texas, licensed in Texas (2076950) and active in the NPI registry since July 2010.
NPPES Registry Identity
Specialties & Licenses
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kelly Detherage's NPI number?
The NPI number for Kelly Detherage is 1245543966. It was assigned to this individual provider in the NPPES registry on July 22, 2010.
Where is Kelly Detherage located?
Kelly Detherage practices at 1201 Holland Lake Drive, Weatherford, TX 76086. The listed phone number is (817) 613-9699.
What is Kelly Detherage's specialty?
The primary specialty registered for this NPI is Physical Therapy Assistant with taxonomy code 225200000X.
When was this NPI record last updated?
The NPPES record for Kelly Detherage was last updated on July 22, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.