| NPI | 1174664247 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL JEFFREY AYRES Owner 502-899-1911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 000996) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2011-11-29 |