Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT7325 | OH |
NPI | 1245553494 |
---|---|
Provider Name | Kelly Gelske |
First Address | Maumee, OH 43537-1371 |
Second Address | Maumee, OH 43537-1371 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2010 |
Last Update Date | 02/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1609899061 | CORPOARATE NPI (01) | OH |