Individual
MRS. KEELY EVERHART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
611 S 13TH ST, FORT PIERCE, FL 34950-4054
(772) 464-5262
Mailing address
611 S 13TH ST, FORT PIERCE, FL 34950-4054
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA13321
FL
Other
Enumeration date
01/03/2017
Last updated
01/03/2017
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