Provider Demographics
NPI:1659836260
Name:RAMOS, KELLI (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KELLI
Middle Name:
Last Name:RAMOS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:KELLI
Other - Middle Name:
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:1002 E BLANCO RD STE B
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-1802
Mailing Address - Country:US
Mailing Address - Phone:830-331-8420
Mailing Address - Fax:
Practice Address - Street 1:1002 E BLANCO RD STE B
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-1802
Practice Address - Country:US
Practice Address - Phone:830-331-8420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-07
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1314447225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist