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General NPI Number Information
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NPI Number | 1780557728
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Entity Type | Individual
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Provider Name | SPENCER ROSS MULLINS
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Gender | Male
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Dates
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Enumeration Date | 09/25/2025
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 633 CHAMBERLIN AVE
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City | FRANKFORT
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State | KY
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Zip | 40601-4220
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Country | US
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Telephone | 502-352-9363
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Fax |
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Provider Business Mailing Address
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Address Line | 123 BILL PERKINS LN
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City | GEORGETOWN
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State | KY
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Zip | 40324-8590
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Country | US
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Telephone | 606-308-3759
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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 | 163546
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License Number State | KY
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