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NPI Code Detail

MEDICARE: JENNIFER GRUBB MS, OTR/L

MEDICARE: JENNIFER GRUBB MS, OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist245363KY

General Provider Information

NPI Number : 1093445256
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER GRUBB MS, OTR/L
Provider Business Mailing Address
First Line : 1670 WHARTON WAY
Second Line :
City : LEXINGTON
State : KY
Zip : 40509-8312
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 690 MASON HEADLEY RD
Second Line :
City : LEXINGTON
State : KY
Zip : 40504-2384
Country : US
Telephone Number : 859-373-0832
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2022
Last Update Date : 06/12/2022

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