Organization
BLUEGRASS DEVELOPMENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA MARTIN (ADMINISTRATOR)
(606) 398-8237
Entity
Organization
Contact information
Practice address
401 BOGLE ST STE 206, SOMERSET, KY 42503-2850
(606) 398-8234
(606) 398-8235
Mailing address
401 BOGLE ST STE 206, SOMERSET, KY 42503-2850
(606) 398-8234
(606) 398-8235
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
01/09/2024
Last updated
08/19/2024
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