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Organization

LAUNCH THERAPY CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
COURTNEY PATRICK OTD, OTR/L (OWNER)
(270) 893-5600
Entity
Organization

Contact information

Practice address
314 HIGHLAND LICK RD, RUSSELLVILLE, KY 42276-9275
(270) 893-5600
Mailing address
610 GREEN VALLEY DR, RUSSELLVILLE, KY 42276-8808
(270) 893-5600

Taxonomy

Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
225XP0200X
Pediatric Occupational Therapist
Primary
235Z00000X
Speech-Language Pathologist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100872860
KY
Enumeration date
05/05/2022
Last updated
05/03/2023
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If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.

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