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General NPI Number Information
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NPI Number | 1033834155
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Entity Type | Organization
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Legal Business Name | JENNIFER METTS PEDIATRIC THERAPY GROUP LLC
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Dates
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Enumeration Date | 10/11/2022
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Last Update Date | 10/05/2023
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Provider Practice Location Address
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Address Line | 301 MIDDLETOWN PARK PL STE G
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City | LOUISVILLE
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State | KY
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Zip | 40243-2515
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Country | US
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Telephone | 812-306-6282
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Fax | 866-292-0327
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Provider Business Mailing Address
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Address Line | 301 MIDDLETOWN PARK PL STE G
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City | LOUISVILLE
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State | KY
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Zip | 40243-2515
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Country | US
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Telephone | 812-306-6282
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Fax | 866-292-0327
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | JENNIFER METTS
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Credential |
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Telephone | 812-306-6282
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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