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NPI Code Detail

MEDICARE: KELSEY KLEVE COTA/L

MEDICARE: KELSEY KLEVE COTA/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy Assistant241142KY

General Provider Information

NPI Number : 1205592540
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELSEY KLEVE COTA/L
Provider Business Mailing Address
First Line : 424 RUDDLES MILLS RD
Second Line :
City : PARIS
State : KY
Zip : 40361-9372
Country : US
Telephone Number : 952-454-4422
Fax Number :
Provider Business Practice Location Address
First Line : 2000 MAIN ST
Second Line :
City : PARIS
State : KY
Zip : 40361-1149
Country : US
Telephone Number : 859-987-5750
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2021
Last Update Date : 11/10/2021

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Directions to “ KELSEY KLEVE COTA/L” Practice Location

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