National Provider Identifier
Tariq Kelly, ATC
Tariq Kelly, ATC is listed in the NPPES registry with a primary specialty of Athletic Trainer in Houghton, NY and a listed phone number of (585) 567-9563.
Profile Overview
- NPI
- 1275074031
- Provider Type
- Individual
- Primary Specialty
- Athletic Trainer
- Enumeration Date
- March 13, 2017
- Last Updated
- March 13, 2017
Practice Location
- 1 Willard Ave
- Houghton, NY 14744-8732
Phone: (585) 567-9563
Specialties
- Athletic Trainer (2255A2300X)
Full Record
- NPI
- 1275074031
- Entity Type
- Individual
- Last Name
- Kelly
- First Name
- Tariq
- Credential
- ATC
- Mailing Street Address
- 1 Willard Ave
- Mailing City
- Houghton
- Mailing State
- NY
- Mailing ZIP Code
- 14744-8732
- Mailing Country
- US
- Mailing Phone
- (585) 567-9563
- Practice Street Address
- 1 Willard Ave
- Practice City
- Houghton
- Practice State
- NY
- Practice ZIP Code
- 14744-8732
- Practice Country
- US
- Practice Phone
- (585) 567-9563
- Enumeration Date
- March 13, 2017
- Last Updated
- March 13, 2017
- Sex
- Male
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Athletic Trainer (2255A2300X)