Individual
KELLY LEONHARDT GRAGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
927 N MAIN ST, MARION, VA 24354-4117
(276) 783-7529
Mailing address
1261 WHITETOP RD, CHILHOWIE, VA 24319-3626
(828) 430-1783
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119008556
VA
Other
Enumeration date
05/26/2020
Last updated
05/26/2020
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