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General NPI Number Information
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NPI Number | 1295357887
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Entity Type | Individual
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Provider Name | JEFFREY SCOTT SELBY OT
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Gender | Male
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Dates
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Enumeration Date | 05/18/2020
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Last Update Date | 05/18/2020
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Provider Practice Location Address
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Address Line | 203 BRUCE CT
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City | DANVILLE
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State | KY
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Zip | 40422-1948
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Country | US
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Telephone | 859-236-9292
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Fax | 859-236-3713
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Provider Business Mailing Address
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Address Line | PO BOX 426
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City | DANVILLE
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State | KY
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Zip | 40423-0426
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Country | US
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Telephone | 859-236-9292
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Fax | 859-236-3713
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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 | 133600
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License Number State | KY
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