Individual
MS. AMANDA LYNN KETELSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
11210 95TH ST, COAL VALLEY, IL 61240-9360
(309) 799-3161
Mailing address
26535 225TH ST, LECLAIRE, IA 52753-9720
(563) 289-2076
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
01734
IA
225X00000X
Occupational Therapist
Primary
—
IL
Other
Enumeration date
06/25/2007
Last updated
07/08/2007
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