Provider Demographics
NPI:1316156805
Name:KELLOGG, KRISTA ZWEIMILLER (MS, PT)
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:ZWEIMILLER
Last Name:KELLOGG
Suffix:
Gender:F
Credentials:MS, PT
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Other - Last Name:
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Mailing Address - Street 1:5754 ELBO RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-8950
Mailing Address - Country:US
Mailing Address - Phone:785-776-6439
Mailing Address - Fax:
Practice Address - Street 1:2600 KIMBALL AVE
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-2655
Practice Address - Country:US
Practice Address - Phone:785-776-6363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-02200225100000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics