Individual
KELSEY LEAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2530 SHASTA WAY, KLAMATH FALLS, OR 97601-4356
(541) 810-7040
Mailing address
5532 VERDICK DR, KLAMATH FALLS, OR 97603-4073
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
—
—
Other
Enumeration date
04/09/2024
Last updated
04/09/2024
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