Healthcare Provider Details

I. General information

NPI: 1669290383
Provider Name (Legal Business Name): JESSICA CURTIS DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JESSICA ANN KELLOGG

II. Dates (important events)

Enumeration Date: 10/01/2024
Last Update Date: 10/01/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 DESALES AVE
CHATTANOOGA TN
37404-1161
US

IV. Provider business mailing address

236 INNSDALE CT
HENDERSON NV
89074-5248
US

V. Phone/Fax

Practice location:
  • Phone: 702-738-5232
  • Fax:
Mailing address:
  • Phone: 702-738-5232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number12293
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: