Individual
HANNAH KELLOGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2296 W DIXON LN, QUEEN CREEK, AZ 85142-7282
(480) 415-8539
Mailing address
2296 W DIXON LN, QUEEN CREEK, AZ 85142-7282
(480) 415-8539
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
013984
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA-013984
STATE BOARD OF PHYSICAL THERAPY
AZ
Enumeration date
06/28/2021
Last updated
06/28/2021
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