Individual
MARYANNE INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
941 PROGRESS RD, ELLIJAY, GA 30540-5599
(912) 491-9235
(678) 951-8226
Mailing address
419 GEORGE AVE, KIRKWOOD, MO 63122-5617
(417) 319-4430
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
119632
IA
Other
Enumeration date
08/22/2023
Last updated
11/21/2023
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