Individual
KOURTNEY MADDOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1500 N RITTER AVE, INDIANAPOLIS, IN 46219-3027
(317) 355-1411
Mailing address
1400 E HANNA AVE, INDIANAPOLIS, IN 46227-3697
(317) 945-2557
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31005503A
IN
Other
Enumeration date
09/06/2013
Last updated
11/04/2021
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