| NPI | 1467700765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE MARTIN Owner 606-831-8752 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: KY R1895) |
| Enumeration Date | 2012-08-17 |
| Last Update Date | 2012-08-17 |