Individual
KELLY SUE FULLENKAMP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
850 W POE RD, BOWLING GREEN, OH 43402-1219
(419) 352-7558
Mailing address
850 W POE RD, BOWLING GREEN, OH 43402-1219
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT.006835
OH
Other
Enumeration date
05/22/2007
Last updated
02/08/2012
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