Drevecky, Kelly Lon

Drevecky, Kelly Lon is an sole proprietor health care provider with primary practice located at 700 Harmony St Nw , Minot ND 58703-2892. He recently has 3 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Neurorehabilitation, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics is his primary health care specialty. Drevecky, Kelly Lon can be contacted via phone (701) 720-5355.

Contact Information

Primary practice address
700 Harmony St Nw Minot ND 58703-2892
Phone: (701) 720-5355
Fax: (701) 839-1311
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X 612 North Dakota
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Neurorehabilitation 225XN1300X 612 North Dakota
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 225XP0200X 612 North Dakota

Profile Details

NPI number 1457303695
LBN Legal business name Drevecky, Kelly Lon
Credentials OT R/L
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 16th, 2006
Last updated Aug 7th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457303695 NPPES
North Dakota MEDICAID 50609

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