Individual
MICHAEL MONTGOMERY MADDOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11901 SHELBYVILLE RD, LOUISVILLE, KY 40243-1040
(502) 245-3774
Mailing address
14705 HEDGEWICK WAY, LOUISVILLE, KY 40245-8454
(502) 396-1440
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
A5753
KY
Other
Enumeration date
03/10/2022
Last updated
03/10/2022
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