Individual provider · Type 1 NPI
Ilana Nicole Kellogg Waasdorp, PT, DPT
Pediatric Physical Therapist · Roanoke, VA
Practice location
1421 3rd St SW
Roanoke, VA 24016-5204
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physical Therapist | 225100000X | PTL.0012174 (CO) |
| Pediatric Physical Therapist Primary | 2251P0200X | 2305212941 (VA) |
Pediatric Physical Therapist: A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Pediatric Physical Therapy, who has demonstrated specialized knowledge and skill in anatomy, histology, including embryonic development, genetics, biomechanics, neurological function, neuroscience, and pathology, behavioral sciences, and understanding of diseases or conditions that necessitate physical th…
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About NPI 1720425549
Ilana Nicole Kellogg Waasdorp, PT, DPT's National Provider Identifier is 1720425549, issued on Jun 3, 2013. The primary taxonomy on file is Pediatric Physical Therapist (2251P0200X), and the practice location is in Roanoke, VA. The record was last updated on Jan 2, 2020.