Individual
ASHLEY RENEE KELLOGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, AMMP
Contact information
Practice address
1650 W NORTHWEST HWY STE 103, GRAPEVINE, TX 76051-8122
(910) 520-6236
Mailing address
6700 OLD STONE DR, FORT WORTH, TX 76137-2334
(910) 520-6236
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT116044
TX
Other
Enumeration date
07/17/2019
Last updated
07/17/2019
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