Provider Demographics
NPI:1730358086
Name:EPTING, KELLY A (PT)
Entity type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:A
Last Name:EPTING
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 US HIGHWAY 80 W
Mailing Address - Street 2:
Mailing Address - City:DEMOPOLIS
Mailing Address - State:AL
Mailing Address - Zip Code:36732-4101
Mailing Address - Country:US
Mailing Address - Phone:334-289-5696
Mailing Address - Fax:334-289-5578
Practice Address - Street 1:101 US HIGHWAY 80 W
Practice Address - Street 2:
Practice Address - City:DEMOPOLIS
Practice Address - State:AL
Practice Address - Zip Code:36732-4101
Practice Address - Country:US
Practice Address - Phone:334-289-5696
Practice Address - Fax:334-289-5578
Is Sole Proprietor?:No
Enumeration Date:2008-02-20
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH3616225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist