Organization
CLARK REGIONAL MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT DONALD FRARACCIO (CEO)
(859) 745-3500
Entity
Organization
Contact information
Practice address
1107 W LEXINGTON AVE, WINCHESTER, KY 40391-1169
(859) 745-3500
(859) 745-3450
Mailing address
1107 W LEXINGTON AVE, WINCHESTER, KY 40391-1169
(859) 745-3500
(859) 745-3450
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
100073
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
45004199
—
KY
Enumeration date
10/29/2007
Last updated
10/29/2007
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