Individual
KELLIE STANDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3033 SARNO RD, MELBOURNE, FL 32934-7229
(321) 255-9200
Mailing address
3361 TITANIC CIR, MELBOURNE, FL 32903-1869
(407) 595-3096
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT17509
FL
Other
Enumeration date
10/09/2016
Last updated
05/23/2017
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