Most Relevant Information
Provider Data
| NPI Number: | 1003034331 |
| Provider Name: | KEL Z GASKIN PROCK MSR, OTR L |
| Entity Type: | Individual |
| Taxonomy Code: | 225XP0200X |
| Specialty: | Occupational Therapist |
| License Number: | 2713 |
Most Important Dates
| Enumeration Date: | 04/23/2007 |
| Last Updated: | 07/31/2023 |
Provider Practice Location
3603 KINGSLEY DR
MYRTLE BEACH
SC
295887713
Practice Location Phone/Fax
| Phone: | 8434245450 |
| Fax: |
Provider Mailing Location
3603 KINGSLEY DR
MYRTLE BEACH
SC
295887713
Provider Mailing Phone/Fax
| Phone: | 8434245450 |
| Fax: |