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Individual

KELLY JEAN TOBIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1330 W 26TH ST, ERIE, PA 16508-1402
(814) 459-9300
(814) 454-7780
Mailing address
7231 STATION RD, ERIE, PA 16510-4850
(814) 899-0906
(814) 454-7780

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC005141L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1013134050002
PA
Enumeration date
07/15/2008
Last updated
07/15/2008
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