Individual
MRS. KELLI SUE HOLMGREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
1532 SHAMROCK DR, DAVENPORT, IA 52807-7602
(563) 340-3665
Mailing address
1532 SHAMROCK DR, DAVENPORT, IA 52807-7602
(563) 340-3665
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
00736
IA
224Z00000X
Occupational Therapy Assistant
057.001964
IL
Other
Enumeration date
11/21/2016
Last updated
11/21/2016
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