MEDICARE: MRS. KELSEY KEARNEY BRYANT OTR/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
1	225XH1200X	Hand Occupational Therapist	3574	GA

General Provider Information

NPI Number	:	1437102860
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KELSEY KEARNEY BRYANT OTR/L

Provider Business Mailing Address
First Line	:	1385 CHELSEY LN
Second Line	:
City	:	ALPHARETTA
State	:	GA
Zip	:	30004-1183
Country	:	US
Telephone Number	:	404-693-9098
Fax Number	:	404-693-9070

Provider Business Practice Location Address
First Line	:	3400 OLD MILTON PKWY # A
Second Line	:	SUITE 350
City	:	ALPHARETTA
State	:	GA
Zip	:	30005-3707
Country	:	US
Telephone Number	:	404-693-9098
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	04/04/2013

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