Individual
CHASE CULLEN IRVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
1301 BROADWAY ST, PADUCAH, KY 42001-2503
(270) 442-9502
Mailing address
1301 BROADWAY ST, PADUCAH, KY 42001-2503
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
282446
KY
Other
Enumeration date
10/25/2023
Last updated
10/25/2023
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