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General NPI Number Information
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NPI Number | 1336483783
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Entity Type | Individual
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Provider Name | BETH KELLENBERGER P.T.
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Gender | Female
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Dates
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Enumeration Date | 11/23/2012
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 10199 WOODFIELD LN
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City | SAINT LOUIS
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State | MO
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Zip | 63132-2922
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Country | US
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Telephone | 877-407-3422
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 W 121ST ST
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City | KANSAS CITY
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State | MO
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Zip | 64145-1089
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Country | US
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Telephone | 309-303-7748
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2001019979
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 11-03058
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License Number State | KS
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