| Marshall Pediatric Therapy, Llc | |
|
109 Wind Haven Dr Ste 100 Nicholasville KY 40356-8010 | |
| (859) 224-2273 | |
| (859) 224-4675 |
| Full Name | Marshall Pediatric Therapy, Llc |
|---|---|
| Speciality | Occupational Therapist |
| Location | 109 Wind Haven Dr Ste 100, Nicholasville, Kentucky |
| Authorized Official Name and Position | Pam Marshall (OCCUPATIONAL THERAPIST / OWNER) |
| Authorized Official Contact | 8592242273 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marshall Pediatric Therapy, Llc 109 Wind Haven Dr Ste 100 Nicholasville KY 40356-8010 Ph: (859) 224-2273 | Marshall Pediatric Therapy, Llc 109 Wind Haven Dr Ste 100 Nicholasville KY 40356-8010 Ph: (859) 224-2273 |
| NPI Number | 1104198472 |
|---|---|
| Provider Enumeration Date | 02/02/2012 |
| Last Update Date | 09/10/2024 |
| Certification Date | 09/10/2024 |
| Medicare PECOS PAC ID | 6406019215 |
|---|---|
| Medicare Enrollment ID | O20120515000163 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104198472 | NPI | - | NPPES |
| 7100275720 | Medicaid | KY | |
| 7100215800 | Medicaid | KY | |
| 7100299670 | Medicaid | KY | |
| 7100328480 | Medicaid | KY | |
| 7100205670 | Medicaid | KY | |
| 7100278210 | Medicaid | KY |
| Provider Name | Pam Marshall |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1902952914 PECOS PAC ID: 2668635483 Enrollment ID: I20120515000203 |
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