Individual
KRYSTAL VERMILLION
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
108 BELFAIR RD, IRMO, SC 29063-8040
(803) 738-6144
Mailing address
PO BOX 4107, IRMO, SC 29063-4027
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4639
SC
225X00000X
Occupational Therapist
OT.009107
OH
Other
Enumeration date
10/21/2015
Last updated
11/06/2015
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