Individual
KELLY MCCUMBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3080 GILMORE AVE, IONIA, IA 50645-9212
(641) 330-8655
Mailing address
3080 GILMORE AVE, IONIA, IA 50645-9212
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
00764
IA
Other
Enumeration date
12/01/2016
Last updated
12/01/2016
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