Individual
KILEY ROSE DEFIBAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
4906 BOXWOOD DR, CHARLESTON, WV 25306-6302
(304) 830-1064
Mailing address
4906 BOXWOOD DR, CHARLESTON, WV 25306-6302
(304) 830-1064
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
1894
WV
Other
Enumeration date
01/15/2020
Last updated
01/15/2020
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