Individual
KELLY HANNON BARGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
4355 PHEASANT RIDGE RD, ROANOKE, VA 24014-5272
(540) 725-8210
Mailing address
1010 5TH ST SW, ROANOKE, VA 24016-4212
(540) 520-0935
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119004541
VA
Other
Enumeration date
01/31/2013
Last updated
01/31/2013
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