Individual
KENNETH WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
303 N HURSTBOURNE PKWY, SUITE 200, LOUISVILLE, KY 40222-5185
(502) 412-5847
Mailing address
414 N 29TH ST, SPRINGFIELD, MI 49037-7847
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
L2531727
MI
Other
Enumeration date
03/11/2014
Last updated
03/11/2014
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