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NPI Code Detail

MEDICARE: ASHLEY KELLEY OT

MEDICARE: ASHLEY KELLEY OT
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
1225X00000XOccupational TherapistOT8763FL

General Provider Information

NPI Number : 1003018375
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY KELLEY OT
Provider Business Mailing Address
First Line : 4412 N DAVIS HWY
Second Line :
City : PENSACOLA
State : FL
Zip : 32503-2756
Country : US
Telephone Number : 850-450-4250
Fax Number :
Provider Business Practice Location Address
First Line : 4406 N DAVIS HWY
Second Line :
City : PENSACOLA
State : FL
Zip : 32503-2756
Country : US
Telephone Number : 850-743-4157
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2007
Last Update Date : 06/21/2013

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Directions to “ ASHLEY KELLEY OT” Practice Location

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