Individual
CARLTON L. KELLOGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1 COMMONS ST, RUTLAND, VT 05701-4652
(802) 747-1857
(802) 747-0129
Mailing address
2041 RUSSELLVILLE RD, SHREWSBURY, VT 05738-9444
(802) 779-6744
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
055.0031529
VT
Other
Enumeration date
09/16/2021
Last updated
09/16/2021
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