Individual
MRS. KELLY JEANETTE RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1000 E WASHINGTON ST., MEDINA, OH 44256
(330) 725-1000
Mailing address
140 SPRUCEWOOD DRIVE, SEVILLE, OH 44273-8810
(330) 769-2035
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7471
OH
Other
Enumeration date
05/04/2007
Last updated
07/08/2007
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