| NPI | 1225460967 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA JENKINS Billing Manager 502-633-1007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2013-08-05 |
| Last Update Date | 2019-05-15 |