Individual
KELLY MATAKOVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
1311 HERR LN STE 205, LOUISVILLE, KY 40222-4384
(502) 419-7811
Mailing address
1311 HERR LN STE 205, LOUISVILLE, KY 40222-4384
(502) 419-7811
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
274237
KY
Other
Enumeration date
01/19/2022
Last updated
01/19/2022
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