Individual
MISS KELLYN E LEYSTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
3541PLOVER ROAD, WISCONSIN RAPIDS, WI 54494-2155
(715) 423-5423
(715) 423-1532
Mailing address
3541PLOVER ROAD, WISCONSIN RAPIDS, WI 54494-2155
(715) 423-5423
(715) 423-1532
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
4735-026
WI
225X00000X
Occupational Therapist
Primary
4735-26
WI
Other
Enumeration date
04/02/2009
Last updated
05/20/2010
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