Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | R2185 | KY |
NPI | 1003014176 |
---|---|
Provider Name | Joseph Freeman |
First Address | Lexington, KY 40513-1497 |
Second Address | Lexington, KY 40513-1497 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2007 |
Last Update Date | 18/04/2014 |