Individual
LESLIE KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
416 S HIGH ST, BUTLER, MO 64730-1827
(660) 679-6158
Mailing address
416 S HIGH ST, BUTLER, MO 64730-1827
(660) 679-6158
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
000393
MO
Other
Enumeration date
08/12/2016
Last updated
08/12/2016
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