Individual
JORDAN LEA KIRKENDOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
236 WARRIOR WAY, NEW RICHMOND, WV 24867
(304) 294-7584
Mailing address
PO BOX 864, OCEANA, WV 24870-0864
(304) 923-9463
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
C2223
WV
Other
Enumeration date
06/25/2024
Last updated
06/25/2024
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