Provider Demographics
NPI:1093318396
Name:FIGI, KELLY CROCKEN (PTA)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:CROCKEN
Last Name:FIGI
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6719 TOWN HALL RD
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62223-8621
Mailing Address - Country:US
Mailing Address - Phone:618-604-2796
Mailing Address - Fax:
Practice Address - Street 1:6719 TOWN HALL RD
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62223-8621
Practice Address - Country:US
Practice Address - Phone:618-604-2796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant