Individual provider · NPI-1

Kelli Knippa, LAT

Physical Medicine & Rehabilitation, Sports Medicine · Lubbock, TX

NPI number1720625544
StatusActive
Last updated in NPPESDec 1, 2019

Details

NPI
1720625544
Entity type
Individual (NPI-1)
Name
Kelli Knippa
Credential
LAT
Sex
Female
Sole proprietor
No
Enumeration date
Dec 1, 2019
Last updated
Dec 1, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2081S0010X Physical Medicine & Rehabilitation, Sports MedicineAT7689TXYes
2083S0010X Preventive Medicine, Sports MedicineAT7689TX

Practice location

4202 44th St
Lubbock, TX 79413-3304

Phone 512-299-6389

Mailing address

311 Rancho Bueno Dr
Georgetown, TX 78628-9520

Phone 512-299-6389

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