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Organization

COMMONWEALTH OF KENTUCKY

Active
Other names
Lee Specialty Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
TANYIKA WAN RHIT (CAO)
(502) 368-2348
Entity
Organization

Contact information

Practice address
4501 LOUISE UNDERWOOD WAY, LOUISVILLE, KY 40216-3987
(502) 368-2348
(502) 371-9067
Mailing address
4501 LOUISE UNDERWOOD WAY, LOUISVILLE, KY 40216-3987
(502) 368-2348
(502) 371-9067

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
A2460
KY

Other

Enumeration date
03/16/2016
Last updated
03/16/2016
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