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Organization

MARSHALL PEDIATRIC THERAPY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PAM MARSHALL OTR/L (OWNER)
(859) 224-2273
Entity
Organization

Contact information

Practice address
141 PROSPEROUS PL, SUITE 24A, LEXINGTON, KY 40509-1848
(859) 224-2273
(859) 224-4675
Mailing address
105 WIND HAVEN DR STE 1, NICHOLASVILLE, KY 40356-8005

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
R3083
KY
235Z00000X
Speech-Language Pathologist
4077
KY

Other

Enumeration date
11/12/2013
Last updated
11/12/2013
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