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General NPI Number Information
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NPI Number | 1104543552
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Entity Type | Individual
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Provider Name | DOUGLAS ALLEN OSBORNE OT/L
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Gender | Male
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Dates
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Enumeration Date | 10/26/2022
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 330 WALLER AVE STE 275
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City | LEXINGTON
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State | KY
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Zip | 40504-2930
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Country | US
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Telephone | 859-447-8600
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Fax | 859-447-8599
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Provider Business Mailing Address
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Address Line | 330 WALLER AVE STE 275
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City | LEXINGTON
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State | KY
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Zip | 40504-2930
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Country | US
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Telephone | 859-447-8600
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Fax | 859-447-8599
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 135420
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License Number State | KY
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