Individual
MRS. KELLY MARIE DOYLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L, BSN
Contact information
Practice address
400 CRATER LAKE AVE, MEDFORD, OR 97504-6808
(541) 613-6505
(541) 770-9212
Mailing address
113 N ELM ST, CANBY, OR 97013-3519
(541) 613-6505
(541) 770-9212
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
878453
TX
225X00000X
Occupational Therapist
120588
TX
225X00000X
Occupational Therapist
Primary
433645
OR
Other
Enumeration date
03/23/2020
Last updated
09/29/2021
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