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NPI Code Detail

MEDICARE: PHYSICAL THERAPY ASSOCIATES INC

MEDICARE: PHYSICAL THERAPY ASSOCIATES INC
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
1225100000XPhysical Therapist002884KY

General Provider Information

NPI Number : 1194932459
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHYSICAL THERAPY ASSOCIATES INC
Provider Business Mailing Address
First Line : 403 N MILES ST
Second Line :
City : ELIZABETHTOWN
State : KY
Zip : 42701-1834
Country : US
Telephone Number : 270-360-9129
Fax Number :
Provider Business Practice Location Address
First Line : 4331 CHURCHMAN AVE
Second Line :
City : LOUISVILLE
State : KY
Zip : 40215-1164
Country : US
Telephone Number : 502-366-1773
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. BRADLEY GORDON COFFMAN
Credential :
Telephone Number : 270-360-9129
Provider Enumeration Date : 05/17/2007
Last Update Date : 01/23/2008

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Directions to “PHYSICAL THERAPY ASSOCIATES INC ” Practice Location

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