Individual
KELLIE ANNE BALKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
317 ENGLISH LEGEND DR, IRMO, SC 29063-8960
(803) 240-1461
Mailing address
317 ENGLISH LEGEND DR, IRMO, SC 29063-8960
(803) 240-1461
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1801
SC
Other
Enumeration date
08/01/2018
Last updated
08/01/2018
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