Individual
MRS. KELLIE MICHELLE VANEYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
805 SUNSET BLVD, CONRAD, MT 59425-1717
(406) 271-2222
Mailing address
12 N DELAWARE ST, CONRAD, MT 59425-1813
(406) 271-2222
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2139
MT
Other
Enumeration date
05/21/2013
Last updated
05/21/2013
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