| NPI | 1992258370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON KELLER Owner/Member 502-322-4884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant |
| 225100000X Physical Therapist | |
| 225200000X Physical Therapy Assistant | |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2016-08-02 |
| Last Update Date | 2016-08-02 |