Individual
KELLY AMYX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSOT
Contact information
Practice address
121 VILLAGE DR, SUITE 103, PORTLAND, TN 37148-1418
(615) 323-7575
(615) 323-0677
Mailing address
PO BOX 681478, FRANKLIN, TN 37068-1478
(866) 800-9147
(615) 591-6601
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2969
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4220815
BCBS OF TENNESSEE
TN
Enumeration date
06/06/2006
Last updated
07/16/2009
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