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NPI Code Detail

MEDICARE: KELLEY L MCCREA OTR/L, CHT

MEDICARE: KELLEY L MCCREA OTR/L, CHT
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 TherapistOC009842PA

General Provider Information

NPI Number : 1841412327
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLEY L MCCREA OTR/L, CHT
Provider Business Mailing Address
First Line : 5151 S 900 E STE 100
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84117-6658
Country : US
Telephone Number : 801-161-3321
Fax Number : 801-261-5942
Provider Business Practice Location Address
First Line : 5151 S 900 E STE 100
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84117-6658
Country : US
Telephone Number : 801-161-3321
Fax Number : 801-261-5942
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2007
Last Update Date : 04/27/2022

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Directions to “ KELLEY L MCCREA OTR/L, CHT” Practice Location

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