Provider Demographics
NPI:1184360364
Name:KELLY, KAILEY (PT, DPT)
Entity type:Individual
Prefix:
First Name:KAILEY
Middle Name:
Last Name:KELLY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:KAILEY
Other - Middle Name:
Other - Last Name:VOGL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:90 GOOD DR STE 201
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-4360
Mailing Address - Country:US
Mailing Address - Phone:717-735-8880
Mailing Address - Fax:717-735-8887
Practice Address - Street 1:90 GOOD DR STE 201
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-4360
Practice Address - Country:US
Practice Address - Phone:717-735-8880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-10
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT030220225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist