Individual
KELLIE BUCKHALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1424 MONTCLAIR RD, IRONDALE, AL 35210-2208
(800) 381-0822
Mailing address
8477 S SUNCOAST BLVD, HOMOSASSA, FL 34446-5028
(800) 381-0822
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4016
AL
Other
Enumeration date
07/06/2023
Last updated
07/06/2023
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