Individual
MRS. KELLY LYNN IRVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS OTRL
Contact information
Practice address
453 MAPLE ST, GROVE CITY, PA 16127-2324
(724) 988-9648
Mailing address
52 POPLAR RD, GREENVILLE, PA 16125-9246
(724) 589-0547
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC009548
PA
Other
Enumeration date
06/25/2007
Last updated
07/08/2007
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