| NPI | 1295276145 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FORREST WAIDE President / CEO 270-871-7503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 001533) |
| Additional Taxonomies | 2251H1200X Physical Therapist, Hand (Licence: KY 10011030054) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: KY 1320) | |
| Enumeration Date | 2017-03-12 |
| Last Update Date | 2017-03-12 |