Individual
KELLY MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
3201 RIVER RD, LEWISBURG, PA 17837
(570) 522-6181
Mailing address
503 VINE ST, MONTOURSVILLE, PA 17754-1309
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP006383
PA
Other
Enumeration date
10/15/2009
Last updated
10/15/2009
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