| NPI | 1215333901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA RENEE BICKWERMERT Physical Therapist 270-775-2790 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 006497) |
| Enumeration Date | 2014-11-07 |
| Last Update Date | 2014-11-07 |