Individual
KYLIE GRACE ORTIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
1400 N 500 E, LOGAN, UT 84341-2455
(435) 716-6440
Mailing address
PO BOX 103, WELLSVILLE, UT 84339-0103
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
13456977-4201
UT
Other
Enumeration date
07/06/2023
Last updated
07/06/2023
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