Individual
MISS KELLIE SUZANNE BURSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
407 CARSON ST, HOT SPRINGS, AR 71901-6852
(870) 356-3622
Mailing address
407 CARSON ST, HOT SPRINGS, AR 71901-6852
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OT-A590
AR
Other
Enumeration date
11/23/2009
Last updated
11/23/2009
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