Healthcare Provider Details

I. General information

NPI: 1003670373
Provider Name (Legal Business Name): KAMERYN KLAYRE ASHURST OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2024
Last Update Date: 02/07/2024
Certification Date: 02/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8706 S US HIGHWAY 25
CORBIN KY
40701-4974
US

IV. Provider business mailing address

641 BRAMBLEWOOD DR
CORBIN KY
40701-7427
US

V. Phone/Fax

Practice location:
  • Phone: 606-677-1166
  • Fax: 606-677-0693
Mailing address:
  • Phone: 606-524-9610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number289847
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: