Provider Demographics
NPI:1700024981
Name:KELLY, PATRICIA MONTEITH (OTR/L)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:MONTEITH
Last Name:KELLY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6135 ROOSEVELT HIGHWAY
Mailing Address - Street 2:ROOSEVELT WARM SPRINGS INSTITUTE FOR REHABILITATION
Mailing Address - City:WARM SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:31830
Mailing Address - Country:US
Mailing Address - Phone:706-655-5637
Mailing Address - Fax:706-655-5661
Practice Address - Street 1:6135 ROOSEVELT HIGHWAY
Practice Address - Street 2:
Practice Address - City:WARM SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:31830
Practice Address - Country:US
Practice Address - Phone:706-655-5637
Practice Address - Fax:706-655-5661
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-27
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT003605225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist