Individual
KYLA DEFRANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
625 STEVENS ST, MEDFORD, OR 97504-6719
(541) 779-3551
Mailing address
16757 S BOONE RD, COLUMBIA STATION, OH 44028-9655
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
04989
OH
224Z00000X
Occupational Therapy Assistant
Primary
296296
OR
Other
Enumeration date
08/24/2015
Last updated
08/24/2015
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