Edward G Frodge, COTA/L

Individual provider Active NPI Occupational Therapy Assistant · Hanson, KY

NPI 1669766895 · NPPES record last updated Jun 6, 2011

Key facts

NPI
1669766895
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
A4807 (KY)
Practice address
7915 Hanson Rd
Hanson, KY 42413-9418
Phone
(270) 322-8465
NPI assigned
Jun 6, 2011
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
A4807KYMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X A4807 KY Yes

Addresses

Primary practice location

7915 Hanson Rd
Hanson, KY 42413-9418

Mailing address

7915 Hanson Rd
Hanson, KY 42413-9418
Phone (270) 322-8465

Other providers in Hanson, KY

All providers in Hanson, KY · Occupational Therapy Assistant in Kentucky

Sources for this page

Verify at the official NPI Registry.