Most Relevant Information
Provider Data
| NPI Number: | 1003547142 |
| Provider Name: | KELLY BRYCE JANSEN OTR/L |
| Entity Type: | Individual |
| Taxonomy Code: | 225X00000X |
| Specialty: | Occupational Therapist |
| License Number: | 2223 |
Most Important Dates
| Enumeration Date: | 06/20/2022 |
| Last Updated: | 06/20/2022 |
Provider Practice Location
2720 SUNSET BLVD
WEST COLUMBIA
SC
291694810
Practice Location Phone/Fax
| Phone: | 8037912000 |
| Fax: |
Provider Mailing Location
2720 SUNSET BLVD
WEST COLUMBIA
SC
291694810
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |