Individual
KELLIE HOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
29335 EAGLE RIDGE DR, BURLINGTON, WI 53105-7607
(262) 661-4523
Mailing address
29335 EAGLE RIDGE DR, BURLINGTON, WI 53105-7607
(262) 661-4523
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
239019
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36119900
—
WI
Enumeration date
06/27/2008
Last updated
06/27/2008
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