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General NPI Number Information
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NPI Number | 1205529161
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Entity Type | Individual
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Provider Name | CHRISTIAN CONNER FORD OTR/L
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Gender | Male
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Dates
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Enumeration Date | 05/29/2023
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Last Update Date | 05/29/2023
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Provider Practice Location Address
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Address Line | 175 HOSPITAL DR
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City | WINCHESTER
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State | KY
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Zip | 40391-9591
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Country | US
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Telephone | 859-745-3500
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Fax |
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Provider Business Mailing Address
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Address Line | 209 GERI LN APT B
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City | RICHMOND
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State | KY
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Zip | 40475-2303
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Country | US
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Telephone | 606-306-5661
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Fax |
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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 | 281235
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License Number State | KY
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