Organization
KELLY SULLIVAN, OTR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY SULLIVAN (OWNER)
(502) 396-1472
Entity
Organization
Contact information
Practice address
444 W KENWOOD DR, LOUISVILLE, KY 40214-2859
(502) 396-1472
Mailing address
444 W KENWOOD DR, LOUISVILLE, KY 40214-2859
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
KY-R2746
KY
Other
Enumeration date
03/27/2012
Last updated
03/27/2012
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