Keely Fortenberry

NPI #1336769306 in Prentiss, Mississippi

Provider Information

NPI Number: 1336769306
Entity Type: Individual
Name: Keely Fortenberry
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Occupational Therapist
Enumeration Date: Apr 20, 2020
Last Updated: Apr 20, 2020

Practice Location

Address: 1102 ROSE ST
City: Prentiss
State: Mississippi
ZIP Code: 39474-5200
Phone: (601) 792-1242

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary

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