Provider Demographics
NPI:1871801027
Name:KELTY, ANNE J (ND, LMT)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:J
Last Name:KELTY
Suffix:
Gender:F
Credentials:ND, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 FLINT ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-3111
Mailing Address - Country:US
Mailing Address - Phone:978-398-4809
Mailing Address - Fax:
Practice Address - Street 1:7 FLINT ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-3111
Practice Address - Country:US
Practice Address - Phone:978-398-4809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-22
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT099.0000195175F00000X
MA6127225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No175F00000XOther Service ProvidersNaturopath