| Mrs Kelly Lee Goodman, OTR | |
|
21211 State Road 57, Kiel, WI 53042-2145 | |
| (920) 740-2747 | |
| Not Available |
| Full Name | Mrs Kelly Lee Goodman |
|---|---|
| Gender | Female |
| Speciality | Occupational Therapist |
| Location | 21211 State Road 57, Kiel, Wisconsin |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528272531 | NPI | - | NPPES |
| 40868400 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | 3954-026 (Wisconsin) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Kelly Lee Goodman, OTR 21211 State Road 57, Kiel, WI 53042-2145 Ph: () - | Mrs Kelly Lee Goodman, OTR 21211 State Road 57, Kiel, WI 53042-2145 Ph: (920) 740-2747 |
Lisa Anne Held, OTR/CCM Occupational Therapist Medicare: Medicare Enrolled Practice Location: 1001 Service Rd, Kiel, WI 53042 Phone: 920-894-2636 Fax: 920-894-1005 | |
Amanda L Dufour, MOTR Occupational Therapist Medicare: Accepting Medicare Assignments Practice Location: 1001 Service Rd, Kiel, WI 53042 Phone: 920-894-2636 Fax: 920-894-1005 |