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:
Health care specialties
| Specialty | Code | License # | 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 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457303695 | NPPES |
| North Dakota | MEDICAID | 50609 |
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