Individual
JEFF PRIDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
109 HOMEWOOD BLVD, GLASGOW, KY 42141-3468
(270) 651-6126
Mailing address
109 HOMEWOOD BLVD, GLASGOW, KY 42141-3468
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
135940
KY
Other
Enumeration date
08/30/2016
Last updated
08/30/2016
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