| NPI | 1972536084 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA DEYOUNG Director Of Billing 502-245-0767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 002216) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: KY R1581) |
| 225X00000X Occupational Therapist (Licence: KY R2779) | |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2020-08-22 |