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General NPI Number Information
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NPI Number | 1497248983
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Entity Type | Individual
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Provider Name | KELLY JONES OTR/L
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Gender | Female
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Dates
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Enumeration Date | 06/11/2018
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Last Update Date | 06/11/2018
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Provider Practice Location Address
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Address Line | 1717 BELLEVUE AVE
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City | RICHMOND
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State | VA
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Zip | 23227-3961
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Country | US
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Telephone | 804-401-0405
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Fax | 317-884-3388
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Provider Business Mailing Address
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Address Line | 7102 ANN CABELL CT
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City | MECHANICSVILLE
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State | VA
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Zip | 23111-5226
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Country | US
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Telephone | 804-401-0405
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Fax | 317-884-3388
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 0119004439
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License Number State | VA
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