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General NPI Number Information
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NPI Number | 1568775617
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Entity Type | Organization
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Legal Business Name | FUSION THERAPY, PLLC
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Dates
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Enumeration Date | 07/19/2010
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Last Update Date | 07/19/2010
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Provider Practice Location Address
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Address Line | 112 STAR MOUNTAIN DR
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City | IRVINE
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State | KY
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Zip | 40336-1136
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Country | US
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Telephone | 859-893-4106
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Fax | 606-723-6029
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Provider Business Mailing Address
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Address Line | 112 STAR MOUNTAIN DR
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City | IRVINE
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State | KY
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Zip | 40336-1136
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Country | US
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Telephone | 859-893-4106
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Fax | 606-723-6029
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST/OWNER
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Name | MRS. KAREN R. MILLER
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Credential | O.T.
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Telephone | 859-893-4106
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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 | R2139
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License Number State | KY
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