Individual
MRS. KELLY EISENHAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1885 S 14TH ST, FERNANDINA, FL 32034-3033
(904) 204-3430
Mailing address
3901 UNIVERSITY BLVD S, JACKSONVILLE, FL 32216-4312
(904) 345-7251
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
18354
FL
Other
Enumeration date
09/11/2019
Last updated
09/11/2019
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