Individual
ALLY VICTORIA KELLERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
9000 W SURA LN, GREENFIELD, WI 53228-3477
(414) 246-6500
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
8220
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100229012
—
WI
Enumeration date
03/02/2023
Last updated
03/02/2026
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