Individual
KELLA ROSE WILLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSOTRL
Contact information
Practice address
2786 56TH ST SW, WYOMING, MI 49418-8708
(616) 261-3960
Mailing address
4495 HERITAGE CT SW APT 9, GRANDVILLE, MI 49418-2643
(231) 740-8696
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201009635
MI
Other
Enumeration date
10/04/2016
Last updated
10/04/2016
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