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General NPI Number Information
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NPI Number | 1801160213
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Entity Type | Organization
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Legal Business Name | DELTA FLEX TRAVEL CO
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Dates
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Enumeration Date | 03/02/2012
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Last Update Date | 03/02/2012
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Provider Practice Location Address
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Address Line | 4305 HARMONY GROVE RD
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City | HOPKINSVILLE
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State | KY
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Zip | 42240-8626
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Country | US
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Telephone | 270-348-1168
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Fax |
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Provider Business Mailing Address
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Address Line | 4305 HARMONY GROVE RD
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City | HOOKINSVILLE
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State | KY
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Zip | 42240
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Country | US
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Telephone | 270-348-1168
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | DR. NATHAN RYAN BOZARTH
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Credential | OTR/L,OTD
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Telephone | 270-349-1169
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State | KY
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