Individual
CAROL LEE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1939 SW TROON AVE, BEND, OR 97702
(503) 468-8757
Mailing address
1939 SW TROON AVE, BEND, OR 97702-3143
(035) 468-8757
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
412866
OR
224Z00000X
Occupational Therapy Assistant
Primary
OC60159972
WA
Other
Enumeration date
05/22/2009
Last updated
12/12/2018
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