MEDICARE: MADELINE MARIE BARTLEY

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
1	225XP0200X	Pediatric Occupational Therapist

General Provider Information

NPI Number	:	1689395626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADELINE MARIE BARTLEY

Provider Business Mailing Address
First Line	:	505 SHOPPERS DR STE 3
Second Line	:
City	:	WINCHESTER
State	:	KY
Zip	:	40391-2808
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	505 SHOPPERS DR STE 3
Second Line	:
City	:	WINCHESTER
State	:	KY
Zip	:	40391-2808
Country	:	US
Telephone Number	:	859-385-4195
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/08/2022
Last Update Date	:	09/08/2022

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Directions to “ MADELINE MARIE BARTLEY ” Practice Location

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