Provider Demographics
NPI:1033834155
Name:JENNIFER METTS PEDIATRIC THERAPY GROUP LLC
Entity Type:Organization
Organization Name:JENNIFER METTS PEDIATRIC THERAPY GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:METTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-306-6282
Mailing Address - Street 1:301 MIDDLETOWN PARK PL STE G
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40243-2515
Mailing Address - Country:US
Mailing Address - Phone:812-306-6282
Mailing Address - Fax:866-292-0327
Practice Address - Street 1:301 MIDDLETOWN PARK PL STE G
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40243-2515
Practice Address - Country:US
Practice Address - Phone:812-306-6282
Practice Address - Fax:866-292-0327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-11
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty