Individual
KELLI MARIE MCCLINTOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
502 N 9TH AVE, VINTON, IA 52332
(319) 472-6372
Mailing address
2968 62ND ST TRAIL, SHELLSBURG, IA 52332
(319) 436-2104
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
00691
IA
Other
Enumeration date
10/07/2011
Last updated
10/07/2011
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