Organization
INDEPENDENCE AT HEART LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KERRIE J ANTHONY OTR/L (OWNER/ MANAGER)
(502) 387-4254
Entity
Organization
Contact information
Practice address
13003 LARKSPUR LN, PROSPECT, KY 40059-9714
(502) 387-4254
Mailing address
13003 LARKSPUR LN, PROSPECT, KY 40059-9714
(502) 387-4254
Taxonomy
Speciality
Code
Description
License number
State
225XN1300X
Neurorehabilitation Occupational Therapist
Primary
R0033
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7100338710
MEDICAID
KY
Enumeration date
05/18/2015
Last updated
05/18/2015
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