| NPI | 1912157520 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY GORDON COFFMAN Executive Director 270-360-9129 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 002884) |
| Enumeration Date | 2008-09-19 |
| Last Update Date | 2008-09-19 |