Organization
FUNCTION DESTINATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KRISTINA L KENNELL (MOT, OTR/L)
(814) 289-6759
Entity
Organization
Contact information
Practice address
445 WESTRIDGE RD STE 301, SOMERSET, PA 15501-1148
(814) 289-6759
Mailing address
1300 HUSBAND RD, SOMERSET, PA 15501-7620
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC012920
PA
Other
Enumeration date
08/17/2017
Last updated
08/17/2017
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