Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | KR4911 | KY |
N | 225XP0200X | Occupational Therapist - Pediatrics | KR4911 | KY |
NPI | 1063535227 |
---|---|
Provider Name | Kim Atkins Grogan |
First Address | Murray, KY 42071-2432 |
Second Address | Murray, KY 42071-2432 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2007 |
Last Update Date | 08/07/2007 |