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1215273065
KELLI MARIE MACK
DETROIT LAKES, MN
NPI
1215273065
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: MN 102620)
Enumeration Date
2012-12-26
Last Update Date
2016-12-05
Business Address
-- KELLI MARIE MACK OTR
1415 MADISON AVE
DETROIT LAKES, MN 56501-4542
Phone number: 218-844-7119
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Mailing Address
-- KELLI MARIE MACK OTR
28910 COUNTY HIGHWAY 54
DETROIT LAKES, MN 56501-7301
Phone number: 218-234-6747
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