MEDICARE: MRS. GINA HARDEN PT, MSED.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	KY001515	KY

General Provider Information

NPI Number	:	1053569418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. GINA HARDEN PT, MSED.

Provider Business Mailing Address
First Line	:	1023 COOPER DR
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40502-2510
Country	:	US
Telephone Number	:	859-333-0738
Fax Number	:

Provider Business Practice Location Address
First Line	:	1023 COOPER DR
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40502-2510
Country	:	US
Telephone Number	:	859-333-0738
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/28/2008
Last Update Date	:	08/28/2008

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