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General NPI Number Information
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NPI Number | 1093694127
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Entity Type | Organization
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Legal Business Name | SPROUTS THERAPY CENTER
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Dates
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Enumeration Date | 09/02/2025
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 237 S MAIN ST
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City | BEAVER DAM
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State | KY
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Zip | 42320-2131
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Country | US
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Telephone | 270-256-9318
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Fax |
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Provider Business Mailing Address
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Address Line | 3972 STATE ROUTE 269
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City | BEAVER DAM
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State | KY
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Zip | 42320-9725
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Country | US
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Telephone | 270-256-9318
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Fax | 270-240-8055
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | BRITTANY CUCCI
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Credential | OTR/L
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Telephone | 270-256-9318
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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