Individual
MRS. COURTNEY H MATTINGLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSOTR/L
Contact information
Practice address
102 FENLEY AVE, LOUISVILLE, KY 40206-2741
(502) 905-5989
Mailing address
102 FENLEY AVE, LOUISVILLE, KY 40206-2741
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
R4179
KY
Other
Enumeration date
02/05/2010
Last updated
10/06/2014
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