Individual
MS. KELLY LYNN THERESE RUTHERFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2850 RUBY VISTA DR, ELKO, NV 89801-1615
(775) 753-6026
Mailing address
1335 NW BROAD ST, MURFREESBORO, TN 37129-4428
(615) 896-7400
(615) 896-5177
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
16-0776
NV
Other
Enumeration date
05/16/2012
Last updated
10/13/2017
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