Individual
KRISTINE KEALEY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
MOORE ORTHOPAEDIC CLINIC, P.A., 14 MEDICAL PARK SUITE 200, COLUMBIA, SC 29203
(803) 227-8000
(803) 227-8015
Mailing address
PO BOX 843384, MOORE ORTHOPAEDIC CLINIC, P.A., BOSTON, MA 02284-3384
(803) 227-8000
(803) 227-8015
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1142
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1142
OT LICENSE #
SC
Enumeration date
03/08/2006
Last updated
07/08/2007
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