Individual
JULIA A KELLOGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, CHT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
01829
MO
2251H1200X
Hand Physical Therapist
9611000171
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12325956
CAQH ID
MO
01
—
P00609549
RAILROAD MEDICARE
MO
Enumeration date
05/17/2006
Last updated
07/25/2016
Update your record
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