Individual
KELLEEN THORNOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
14265 MIDLOTHIAN TPKE, MIDLOTHIAN, VA 23113-6560
(804) 464-2323
(804) 464-2313
Mailing address
14265 MIDLOTHIAN TPKE, MIDLOTHIAN, VA 23113-6560
(804) 464-2323
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306605237
VA
Other
Enumeration date
05/04/2022
Last updated
05/04/2022
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