Individual
MRS. KAYLA JO CARRILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
213 W MASON ST STE B, ODESSA, MO 64076-1262
(417) 848-2262
Mailing address
7912 RASPBERRY SWIRL RD, ODESSA, MO 64076-7423
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
20050335768
MO
225X00000X
Occupational Therapist
Primary
2012023105
MO
Other
Enumeration date
07/27/2012
Last updated
08/23/2023
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