Individual
MRS. KELLY MARIE FENWICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
2817 REILLY ROAD, WAMC STOP A MCXC DPC ED CREDENTIALS DEPARTMENT OF THE A, FORT BRAGG, NC 28310-7301
(910) 907-7110
Mailing address
2817 REILLY ROAD, WOMACK ARMY MEDICAL CENTER MCXC COD CREDENTIALS, FORT BRAGG, NC 28310
(910) 907-8922
(910) 907-6069
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4921
NC
Other
Enumeration date
12/28/2006
Last updated
07/08/2007
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