Provider Demographics
NPI:1871202150
Name:O'KELLY, BRIA (PT, DPT)
Entity type:Individual
Prefix:
First Name:BRIA
Middle Name:
Last Name:O'KELLY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 REGIMENT LN
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22405-5783
Mailing Address - Country:US
Mailing Address - Phone:470-226-4067
Mailing Address - Fax:
Practice Address - Street 1:3508 CONNECTICUT AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-2401
Practice Address - Country:US
Practice Address - Phone:202-897-3890
Practice Address - Fax:202-836-8580
Is Sole Proprietor?:No
Enumeration Date:2022-11-16
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305215497225100000X
DCPT210002303225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist