Provider Demographics
NPI:1689867459
Name:KELLOGG, DIONNE YVELLE (DC)
Entity Type:Individual
Prefix:DR
First Name:DIONNE
Middle Name:YVELLE
Last Name:KELLOGG
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1746 GENERAL GEORGE PATTON DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-2935
Mailing Address - Country:US
Mailing Address - Phone:615-221-8033
Mailing Address - Fax:615-221-8035
Practice Address - Street 1:1746 GENERAL GEORGE PATTON DR
Practice Address - Street 2:SUITE 102
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-2935
Practice Address - Country:US
Practice Address - Phone:615-221-8033
Practice Address - Fax:615-221-8035
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-24
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2164111N00000X
IL38-010960111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor