Provider Demographics
NPI:1881147783
Name:LOEHR, KELLIE (MS, LAT, ATC)
Entity type:Individual
Prefix:
First Name:KELLIE
Middle Name:
Last Name:LOEHR
Suffix:
Gender:F
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 HIGHMEADOW RD
Mailing Address - Street 2:
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-2102
Mailing Address - Country:US
Mailing Address - Phone:985-502-9132
Mailing Address - Fax:
Practice Address - Street 1:233 HIGHMEADOW RD
Practice Address - Street 2:
Practice Address - City:REISTERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21136-2102
Practice Address - Country:US
Practice Address - Phone:985-502-9132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-27
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA006742255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer