Individual
EMILY RENEE' LAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
420 JETT DR, JACKSON, KY 41339-9621
(606) 666-2456
Mailing address
43 GROSS LOOP, JACKSON, KY 41339-8625
(606) 560-1227
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
168904
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000
N/A
—
Enumeration date
06/26/2018
Last updated
06/26/2018
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