Individual
KELSEY BOWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
3741 ROME DR STE A, LAFAYETTE, IN 47905-4490
(765) 250-3662
Mailing address
3741 ROME DR STE A, LAFAYETTE, IN 47905-4490
(765) 250-3662
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
99030729A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
—
Enumeration date
04/03/2008
Last updated
03/05/2019
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