Individual
MRS. JILL BLACKBURN MUDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3100 CLAY ST, PADUCAH, KY 42001-4075
(270) 442-6884
Mailing address
265 SPRING VALLEY DR, PADUCAH, KY 42003-8885
(270) 559-8299
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
R5498
KY
Other
Enumeration date
05/28/2013
Last updated
05/28/2013
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