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Individual
KELLI KNIPPA
Active
Individual
KELLI KNIPPA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
AT7689
TX
2083S0010X
Sports Medicine (Preventive Medicine) Physician
AT7689
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10585751
ANY
—
Enumeration date
12/01/2019
Last updated
12/01/2019
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