Organization
S MASTERSON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON MARIE MASTERSON OTR/L (OCCUPATIONAL THERAPIST)
(502) 386-1072
Entity
Organization
Contact information
Practice address
3504 WEXFORD DR, LOUISVILLE, KY 40218-2143
(502) 386-1072
(502) 324-7830
Mailing address
3504 WEXFORD DR, LOUISVILLE, KY 40218-2143
(502) 386-1072
(502) 324-7830
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100080320
—
KY
Enumeration date
08/07/2020
Last updated
08/07/2020
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