Individual
JAIDE KELLI BAMMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
1001 LAURENCE AVE, JACKSON, MI 49202-2979
(517) 750-4777
Mailing address
1001 LAURENCE AVE, JACKSON, MI 49202-2979
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
5201013249
MI
Other
Enumeration date
02/13/2023
Last updated
02/28/2024
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