Individual
MR. DEREK THOMAS EDLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
814 OLD EKRON RD, BRANDENBURG, KY 40108-1149
(270) 422-2148
Mailing address
99 MADISON AVENUE, BRANDENBURG, KY 40108
(270) 828-8059
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
A3750
KY
Other
Enumeration date
07/02/2007
Last updated
07/08/2007
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