MISS Kelley Nicole Tate, P.T.

NPI #1003811258 in Boonville, Missouri

Provider Information

NPI Number: 1003811258
Entity Type: Individual
Name: MISS Kelley Nicole Tate, P.T.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: P.T.
Enumeration Date: Jun 15, 2005
Last Updated: Feb 20, 2025

Practice Location

Address: 1420 W ASHLEY RD
City: Boonville
State: Missouri
ZIP Code: 65233-2112
Phone: (660) 882-6115

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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Organizations

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