Individual
KRISTEN INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1225 BROADRICK DR, DALTON, GA 30720-2504
(706) 272-6199
Mailing address
1225 BROADRICK DR, DALTON, GA 30720-2504
(706) 272-6199
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT006587
GA
Other
Enumeration date
06/19/2015
Last updated
11/21/2016
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