Individual
ANGELA KELLAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2300 S OAK GROVE RD, ENNIS, TX 75119-6841
(972) 875-8641
Mailing address
1711 W JAMESTOWN DR, ENNIS, TX 75119-2127
(214) 497-1489
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2022622
TX
Other
Enumeration date
12/04/2018
Last updated
12/04/2018
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