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1174006209
SHAUN VICKERY
MADISONVILLE, KY
NPI
1174006209
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: KY 004425)
Enumeration Date
2018-09-14
Last Update Date
2018-09-14
Business Address
SHAUN VICKERY PT, MPT
425 ISLAND FORD ROAD
MADISONVILLE, KY 42431
Phone number: 270-825-0166
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Mailing Address
SHAUN VICKERY PT, MPT
106 GENEVIEVE DR
MADISONVILLE, KY 42431-5806
Phone number: 270-836-6559
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