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NPI Code Detail

MEDICARE: CHRISTINE CLAIRE KELLOGG P.T., D.O.M.

MEDICARE:   CHRISTINE CLAIRE KELLOGG  P.T., D.O.M.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171100000XAcupuncturistAP1643FL
2225100000XPhysical TherapistPT14546FL

General Provider Information

NPI Number : 1528037884
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE CLAIRE KELLOGG P.T., D.O.M.
Provider Business Mailing Address
First Line : 5702 BAYWATER DR
Second Line : TAMPA
City : TAMPA
State : FL
Zip : 33615-3519
Country : US
Telephone Number : 850-294-0554
Fax Number :
Provider Business Practice Location Address
First Line : 3001 N ROCKY POINT DR E
Second Line : SUITE 185
City : TAMPA
State : FL
Zip : 33607-5810
Country : US
Telephone Number : 813-289-9613
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2006
Last Update Date : 05/08/2008

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Directions to “ CHRISTINE CLAIRE KELLOGG P.T., D.O.M.” Practice Location

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