Individual
MS. KELLY JO SALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2512 NEW PINE DR, ALTOONA, WI 54720-1378
(715) 833-0400
(715) 833-0397
Mailing address
E6495 420TH AVE, MENOMONIE, WI 54751-5630
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1327-027
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40809700
—
WI
Enumeration date
05/07/2007
Last updated
07/08/2007
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