Individual
KELSEY BOLTON GRANTHUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
340 MENDEL PKWY W, MONTGOMERY, AL 36117-5406
(334) 532-0220
Mailing address
4049 WARES FERRY RD, MONTGOMERY, AL 36109-2916
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4651
AL
Other
Enumeration date
02/23/2018
Last updated
11/09/2020
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