Individual
TRACY LAWAND KELSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1127 PERSINGER RD SW, ROANOKE, VA 24015-3829
(540) 343-1696
Mailing address
4951 POMEROY RD NW, ROANOKE, VA 24017-4627
(540) 793-1153
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1056802
VA
Other
Enumeration date
03/28/2007
Last updated
07/08/2007
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