Individual ProviderJillian KelleyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address101 N Plains Industrial Rd, Wallingford, CT 06492-2360(203) 265-0018(631) 580-5200PECOS EnrollmentBased on the most recent information from CMS, provider Jillian Kelley does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1588019038Provider TypeIndividualFull NameKelley, JillianCredentialDPTGenderFemaleSole ProprietorNoEnumeration Date5/3/2016Last Updated5/3/2016Contact InformationPractice LocationPractice Address101 N Plains Industrial Rd, Wallingford, CT 06492-2360Phone(203) 265-0018Fax(203) 265-4368Mailing LocationMailing Address4175 Veterans Memorial Hwy, Suite 202, Ronkonkoma, NY 11779-7639Phone(631) 580-5200Fax(631) 580-5222Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense010391Connecticut