| NPI | 1629329040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNE M BURNETT Office Manager 502-633-1007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 225100000X Physical Therapist | |
| Enumeration Date | 2012-09-25 |
| Last Update Date | 2017-03-07 |