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1023343092
KELLY ALAN WHITE
DOWNERS GROVE, IL
NPI
1023343092
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: IL 057.000794)
Enumeration Date
2009-10-08
Last Update Date
2009-10-08
Business Address
Mr. KELLY ALAN WHITE COTA/L
4334 WASHINGTON ST
DOWNERS GROVE, IL 60515-2837
Phone number: 630-971-0815
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Mailing Address
Mr. KELLY ALAN WHITE COTA/L
4334 WASHINGTON ST
DOWNERS GROVE, IL 60515-2837
Phone number: 630-971-0815
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