Individual
KELLY WEBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2120 60TH AVE NE, WILLMAR, MN 56201-9140
(320) 420-4080
Mailing address
3522 12TH AVE SE, SAINT CLOUD, MN 56304-9531
(320) 214-7082
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
101475
MN
Other
Enumeration date
04/28/2010
Last updated
04/28/2010
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