Most Relevant Information
Provider Data
| NPI Number: | 1003670340 |
| Provider Name: | KELLY KLINE SLP |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | 17984 |
Most Important Dates
| Enumeration Date: | 02/07/2024 |
| Last Updated: | 02/07/2024 |
Provider Practice Location
1871 NE STEPHENS ST
ROSEBURG
OR
974701433
Practice Location Phone/Fax
| Phone: | 5414404777 |
| Fax: |
Provider Mailing Location
1871 NE STEPHENS ST
ROSEBURG
OR
974701433
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |