Individual
KELLY SCHAIDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1485 INTERNATIONAL PKWY, HEATHROW, FL 32746-5303
(800) 798-6035
Mailing address
118 DUTCH LN, METAMORA, IL 61548-9733
(309) 251-2267
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
VA
Other
Enumeration date
10/17/2007
Last updated
10/17/2007
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