Individual
MS. KATHLEEN BRUCE KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR L
Contact information
Practice address
500 W FORT ST, VA HOSPITAL, BOISE, ID 83702
(208) 422-1000
Mailing address
500 W FORT ST, VA HOSPITAL, BOISE, ID 83702
(208) 422-1000
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT147
ID
Other
Enumeration date
08/04/2008
Last updated
08/04/2008
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