Individual
KELLY GARLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1014 FORSYTH ST, MACON, GA 31201-2051
(478) 201-6748
Mailing address
2490 RIVERSIDE DR, STE B, MACON, GA 31204-1787
(478) 633-6633
(478) 633-4295
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT006276
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT006276
GA LICENSE
GA
Enumeration date
10/12/2015
Last updated
10/12/2015
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