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General NPI Number Information
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NPI Number | 1922585520
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Entity Type | Organization
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Legal Business Name | SMITH OCCUPATIONAL THERAPY, LLC
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Dates
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Enumeration Date | 07/26/2018
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Last Update Date | 07/26/2018
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Provider Practice Location Address
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Address Line | 8000 LOTTS CREEK RD
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City | HAZARD
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State | KY
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Zip | 41701-9046
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Country | US
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Telephone | 606-233-2812
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Fax |
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Provider Business Mailing Address
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Address Line | 8000 LOTTS CREEK RD
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City | HAZARD
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State | KY
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Zip | 41701-9046
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Country | US
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Telephone | 606-233-2812
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | CARLA R SMITH
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Credential | MS, OTR/L
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Telephone | 606-233-2812
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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 | 134122
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License Number State | KY
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