Individual
MISS KELLIE LEIGH TATUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
227 LANDMARK DRIVE, STUART, VA 24171
(276) 694-0124
(276) 694-0125
Mailing address
PO BOX 1416, STUART, VA 24171-1416
(276) 694-0124
(276) 694-0125
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119005287
VA
Other
Enumeration date
03/01/2011
Last updated
07/20/2011
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