Individual
KELLY HAWTHORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
701 10TH ST SE, CEDAR RAPIDS, IA 52403-1251
(319) 398-6915
Mailing address
2456 BLUEGRASS ST, MARION, IA 52302-6004
(773) 531-4547
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
03085
IA
Other
Enumeration date
11/09/2023
Last updated
11/09/2023
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