Individual
KELLY WHITTAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
1802 BRAEBURN DR, SALEM, VA 24153-7357
(540) 772-3770
(540) 725-4565
Mailing address
815 DAY AVE SW APT 1, ROANOKE, VA 24016-3819
(330) 858-0336
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305211944
VA
Other
Enumeration date
12/08/2022
Last updated
12/08/2022
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