Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kelly Jean Detherage, PTA

Individual provider Physical Therapy Assistant · NPI 1245543966

Kelly Jean Detherage, PTA is a Physical Therapy Assistant in Weatherford, Texas. Licensed in Texas. Registered with an NPI since 2010.

Licensed in
TX
In the registry since
2010
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

1201 Holland Lake Dr
Weatherford, TX 76086
Phone: (817) 613-9699
Fax: (817) 594-9786
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 2076950 (TX)

Record details

NPI number1245543966
Entity typeIndividual (Type 1)
GenderFemale
Credentials PTA
Sole proprietorNo
NPI enumeratedJuly 22, 2010
Last updated in NPPESJuly 22, 2010

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