Dovetail Pediatric Therapy is a
Clinic/center - Rehabilitation based in Radcliff, Kentucky. Dovetail Pediatric Therapy is licensed to practice in Kentucky (license number BOTOCT) and their current practice location is
645 Knox Blvd, Radcliff, Kentucky. It can be reached at their office (for appointments etc.) via phone at
(270) 351-2224.
NPI number for Dovetail Pediatric Therapy is 1720486012 and their current mailing address is Po Box 558, Radcliff, Kentucky. Dovetail Pediatric Therapy
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1720486012.
Healthcare Provider's Profile
| Full Name | Dovetail Pediatric Therapy |
|---|
| Type | Facility |
|---|
| Speciality | Clinic/center - Rehabilitation |
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| Location | 645 Knox Blvd, Radcliff, Kentucky |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1720486012
- Provider Enumeration Date: 12/18/2014
- Last Update Date: 01/23/2015
Medical Identifiers
Medical identifiers for Dovetail Pediatric Therapy such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1720486012 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 225XP0200X | Occupational Therapist - Pediatrics | BOTOCT00210728 (Kentucky) | Secondary |
| 252Y00000X | Early Intervention Provider Agency | BOTOCT00210728 (Kentucky) | Secondary |
| 261QR0400X | Clinic/center - Rehabilitation | BOTOCT (Kentucky) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dovetail Pediatric Therapy is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dovetail Pediatric Therapy
Po Box 558,
Radcliff, KY 40159-0558
Ph: (270) 351-2224 | Dovetail Pediatric Therapy
645 Knox Blvd,
Radcliff, KY 40160-1514
Ph: (270) 351-2224 |
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