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Kel Z Gaskin Prock, MSR, OTR L

Occupational Therapist in Myrtle Beach, SC. Individual provider (NPI-1).

NPI number1003034331
StatusActive
Last updated in NPPESJul 31, 2023

Details

NPI
1003034331
Entity type
Individual (NPI-1)
Name
Kel Z Gaskin Prock
Credential
MSR, OTR L
Sex
Female
Sole proprietor
Yes
Enumeration date
Apr 23, 2007
Certification date
Jul 31, 2023
Last updated
Jul 31, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225X00000X Occupational Therapist2713SCYes
225XP0200X Occupational Therapist, Pediatrics2713SC

Other names

  • Kelly Elizabeth Prock (Other Name)

Practice location

3603 Kingsley Dr
Myrtle Beach, SC 29588-7713

Phone 843-424-5450

Mailing address

3603 Kingsley Dr
Myrtle Beach, SC 29588-7713

Phone 843-424-5450

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