Healthcare Provider Details

I. General information

NPI: 1396727186
Provider Name (Legal Business Name): PAUL A. CASTLE P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: PAUL CASTLE P.T.

II. Dates (important events)

Enumeration Date: 11/16/2005
Last Update Date: 06/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 GREENUP AVE
ASHLAND KY
41101-1953
US

IV. Provider business mailing address

213 15TH ST
ASHLAND KY
41101-7623
US

V. Phone/Fax

Practice location:
  • Phone: 606-324-0540
  • Fax: 606-324-0616
Mailing address:
  • Phone: 606-325-3341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number002418
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT 07896
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number001579
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: