Organization
MIND, BODY & SPIRIT FITNESS, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KENNESHA DENISE GREEN OTR/L (OCCUPATIONAL THERAPIST/CEO)
(502) 821-5627
Entity
Organization
Contact information
Practice address
8225 WHIPPS MILL RD, LOUISVILLE, KY 40222-5403
(502) 821-5627
Mailing address
PO BOX 16088, LOUISVILLE, KY 40256-0088
(502) 821-5627
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
KY-R2776
KY
Other
Enumeration date
05/25/2009
Last updated
11/30/2009
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