Individual
JON GARRICK KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
702 10TH AVE NW, DODGE CENTER, MN 55927-9172
(507) 635-6415
Mailing address
702 10TH AVE NW, DODGE CENTER, MN 55927-9172
(507) 635-6415
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
201600
MN
Other
Enumeration date
02/01/2021
Last updated
02/01/2021
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