Individual
KELLY NICHOLE GLOVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2412 GREATSTONE PT, LEXINGTON, KY 40504-3274
(859) 224-4081
Mailing address
2173 AZALEA DR, LEXINGTON, KY 40504-3303
(859) 420-2868
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
266923
KY
Other
Enumeration date
04/07/2021
Last updated
04/07/2021
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