Individual
KYRA JO THURSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
501 N 17TH AVE, BEECH GROVE, IN 46107-1169
(317) 219-3889
(317) 324-3965
Mailing address
PO BOX 388, DAYTON, OH 45409-0388
(937) 294-2468
(937) 294-2394
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31006912A
IN
Other
Enumeration date
01/03/2020
Last updated
01/07/2020
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