Individual
KELLIE WHITON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
14139363-2401
UT
225100000X
Physical Therapist
4362
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4327020
—
UT
Enumeration date
09/01/2016
Last updated
02/21/2025
Update your record
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