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Organization
GREEN RIVER OCCUPATIONAL THERAPY, LLC
Active
Organization
GREEN RIVER OCCUPATIONAL THERAPY, LLC
Active
Other names
Green River Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA MATTINGLY-MARDIS OTR/L (OWNER/OTR)
12706928826
Entity
Organization
Contact information
Practice address
991 MARTIN RD, CAMPBELLSVILLE, KY 42718-9726
(270) 789-4241
(270) 789-6531
Mailing address
991 MARTIN RD, CAMPBELLSVILLE, KY 42718-9726
(270) 789-4241
(270) 789-6531
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
R2253
KY
Other
Enumeration date
08/06/2007
Last updated
08/06/2007
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