Individual
MRS. KELLI JO SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
1033 N HIGHWAY 11, MANCHESTER, KY 40962-5478
(606) 598-6163
Mailing address
243 HOWARD RD, LONDON, KY 40744-9143
(859) 402-0306
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
R3388
KY
Other
Enumeration date
06/21/2007
Last updated
07/08/2007
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