Provider Demographics
NPI:1437379807
Name:KELTNER, KRISTIN LEA (OTR)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:LEA
Last Name:KELTNER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 N CRESS DR
Mailing Address - Street 2:
Mailing Address - City:PEKIN
Mailing Address - State:IN
Mailing Address - Zip Code:47165-7860
Mailing Address - Country:US
Mailing Address - Phone:812-620-3246
Mailing Address - Fax:812-967-2488
Practice Address - Street 1:512 N CRESS DR
Practice Address - Street 2:
Practice Address - City:PEKIN
Practice Address - State:IN
Practice Address - Zip Code:47165-7860
Practice Address - Country:US
Practice Address - Phone:812-620-3246
Practice Address - Fax:812-967-2488
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31002352A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist