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General NPI Number Information
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NPI Number | 1780181537
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Entity Type | Individual
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Provider Name | MICHAEL D. CHITWOOD OCCUPATIONAL THERAPI
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Gender | Male
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Dates
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Enumeration Date | 04/09/2018
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Last Update Date | 04/09/2018
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Provider Practice Location Address
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Address Line | 200 MEDICAL VILLAGE DRIVE
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City | EDGEWOOD
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State | KY
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Zip | 41017
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Country | US
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Telephone | 859-301-8286
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Fax | 859-578-5975
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Provider Business Mailing Address
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Address Line | PO BOX 638880
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City | CINCINNATI
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State | OH
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Zip | 45263-8880
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Country | US
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Telephone | 859-301-9286
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Fax | 859-578-5975
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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 | 134418
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License Number State | KY
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