Basic Information
| Provider Information | |||||||||
| NPI: | 1669672184 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SLOTHOWER | ||||||||
| FirstName: | KELLY | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 910 FOULK RD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198033158 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3024771536 | ||||||||
| FaxNumber: | 3024771564 | ||||||||
| Practice Location | |||||||||
| Address1: | 150 MONUMENT RD STE 110 | ||||||||
| Address2: | |||||||||
| City: | BALA CYNWYD | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190041725 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4842681350 | ||||||||
| FaxNumber: | 4842681351 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/23/2007 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | J10002778 | DE | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 2251S0007X | 10613 | NC | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Sports | 2251X0800X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic |
No ID Information.