Provider Demographics
NPI:1568775617
Name:FUSION THERAPY, PLLC
Entity Type:Organization
Organization Name:FUSION THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:R
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:859-893-4106
Mailing Address - Street 1:112 STAR MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:KY
Mailing Address - Zip Code:40336-1136
Mailing Address - Country:US
Mailing Address - Phone:859-893-4106
Mailing Address - Fax:606-723-6029
Practice Address - Street 1:112 STAR MOUNTAIN DR
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:KY
Practice Address - Zip Code:40336-1136
Practice Address - Country:US
Practice Address - Phone:859-893-4106
Practice Address - Fax:606-723-6029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-19
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR2139225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty