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General NPI Number Information
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NPI Number | 1760527477
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Entity Type | Organization
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Legal Business Name | OCCUPATIONAL THERAPY INTERVENTIONS, INC.
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 155 MIZE BRANCH RD
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City | MANCHESTER
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State | KY
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Zip | 40962-6632
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Country | US
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Telephone | 606-598-4667
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Fax | 606-598-4667
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Provider Business Mailing Address
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Address Line | 155 MIZE BRANCH RD
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City | MANCHESTER
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State | KY
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Zip | 40962-6632
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Country | US
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Telephone | 606-598-4667
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Fax | 606-598-4667
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Authorized Official
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Title or Position | PRESIDENT
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Name | CAROL RENEE MARCUM
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Credential | OT
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Telephone | 606-598-4667
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | KY-R1597
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License Number State | KY
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