Kelli Marie Detwiler, LPTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

Practice address

2194 E Boatfield Ave
Burton, MI 48529-1716

Phone

(810) 835-6114

NPI assigned

Nov 30, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Miss Kelli Marie Holland Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1322611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1154698561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2194 E BOATFIELD AVE",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485291716",
            "telephone_number": "810-835-6114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2194 E BOATFIELD AVE",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485291716",
            "telephone_number": "810-835-6114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETWILER",
        "first_name": "KELLI",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LPTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-30",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLI",
            "last_name": "HOLLAND",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tianna Davis
• Lakshmi Kantharao Davu
• Patrice Ann Dembo, RPH
• Wykena Sharee Demson
• Sachin H Desai, PHYSICAL THERAPIST
• Trina Leane Dewar, OTR
• Lynn Dewitt
• Gary Albert Dickens, D.C.
• Matthew Price Dickson, PH.D.
• Chantel Didominicis

• Physical Therapy Assistant in Burton, MI
• Providers in Burton, MI by specialty
• Physical Therapy Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.