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Individual

KELLI FUNKHOUSER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, PT

Contact information

Practice address
4194 INNSLAKE DR, GLEN ALLEN, VA 23060-3344
(804) 217-8000
Mailing address
371 SILVER OAKS DR, HARRISONBURG, VA 22801-3578

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305207303
VA
225100000X
Physical Therapist
PT26509
CA

Other

Enumeration date
11/27/2011
Last updated
04/04/2012
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