Individual
KRISTI LEE KELLOGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
7330 FERN AVE, SHREVEPORT, LA 71105-4971
(866) 730-0707
Mailing address
7330 FERN AVE, SHREVEPORT, LA 71105-4971
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
006809-1
NY
Other
Enumeration date
06/04/2009
Last updated
06/04/2009
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