Individual
KELLY L MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
500 GRANT AVE, OMRO, WI 54963-1398
(920) 685-2755
Mailing address
1201 NATURE TRAIL DR, NEENAH, WI 54956-1676
(248) 563-9052
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
8213-26
WI
Other
Enumeration date
09/07/2023
Last updated
09/07/2023
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