Individual
KELLY BEATTIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2626 SAINT JOE CENTER RD, FORT WAYNE, IN 46825-5042
(260) 497-0328
Mailing address
2626 SAINT JOE CENTER RD, FORT WAYNE, IN 46825-5042
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001776A
IN
Other
Enumeration date
11/23/2020
Last updated
11/23/2020
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