Individual
MRS. KACI J ROLLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
10757 W ROSTED RD, LAKE CITY, MI 49651-8203
(231) 779-2908
Mailing address
10757 W ROSTED RD, LAKE CITY, MI 49651-8203
(231) 779-2908
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201003324
MI
Other
Enumeration date
12/15/2011
Last updated
12/15/2011
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