Brook Keller, COTAL
Individual provider Active NPI Occupational Therapy Assistant · Birch Run, MI
NPI 1215565445 · NPPES record last updated Apr 29, 2020
Key facts
- NPI
- 1215565445
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 5202008485 (MI)
- Practice address
- 8371 Fairlane Dr Apt 5
Birch Run, MI 48415-9774 - Phone
- (989) 323-7489
- NPI assigned
- Apr 1, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5202008485 | MI | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | |||
| Occupational Therapy Assistant | 224Z00000X | 5202008485 | MI | Yes |
Addresses
Primary practice location
8371 Fairlane Dr Apt 5
Birch Run, MI 48415-9774
Mailing address
8371 Fairlane Dr Apt 5
Birch Run, MI 48415-9774
Other providers in Birch Run, MI
- Ashton Hoose-Kangas
- Hope Primary Care of Birch Run PLLC
- Hope Urgent Care Birch Run PLLC
- Julia Jamrog
- Taylia Jones
- Amanda Kleinfeld
- Savannah Krall
- Yvonne Young Lamphier
- Bethany Larose
- Wendy Lasley
All providers in Birch Run, MI · Occupational Therapy Assistant in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.