Individual
MRS. MARY MECKERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
1050 CHINOE RD, SUITE 350, LEXINGTON, KY 40502-6571
(859) 317-4038
Mailing address
543 PORT DR, AVON, IN 46123-1237
(812) 499-1692
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32000636A
IN
Other
Enumeration date
02/08/2017
Last updated
02/08/2017
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