Individual
KELLY ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6633 TULA LN, LAKELAND, FL 33809-4320
(561) 254-5379
Mailing address
6633 TULA LN, LAKELAND, FL 33809-4320
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA8039
FL
Other
Enumeration date
10/17/2019
Last updated
11/01/2019
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