Individual
KELLEY WARE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 LINCOLN DR, S CHARLESTON, WV 25309-2304
(304) 768-4400
Mailing address
1000 LINCOLN DR, S CHARLESTON, WV 25309-2304
(304) 768-4400
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
C1654
WV
Other
Enumeration date
03/13/2014
Last updated
03/13/2014
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