Organization
MARISSA E. KELLEY, OTR/L, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARISSA KELLEY OTR/L (OWNER)
(207) 594-5076
Entity
Organization
Contact information
Practice address
3208 CAMDEN RD, WARREN, ME 04864-4124
(207) 594-5076
(207) 594-7339
Mailing address
3208 CAMDEN RD, WARREN, ME 04864-4124
(207) 594-5076
(207) 594-7339
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OT1342
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
212770000
—
ME
Enumeration date
07/21/2010
Last updated
07/21/2010
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