Individual
KELLY D GRANTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1100 BLYTHE BLVD, CHARLOTTE, NC 28203-5814
(704) 355-4645
Mailing address
1100 BLYTHE BLVD, CHARLOTTE, NC 28203-5814
(704) 355-4645
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6924
NC
Other
Enumeration date
02/17/2009
Last updated
02/17/2009
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