Healthcare Provider Details

I. General information

NPI: 1710893227
Provider Name (Legal Business Name): BRANDON LAYNE PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

480 23RD ST
ASHLAND KY
41101-7858
US

IV. Provider business mailing address

3333 RED FOX DR
CATLETTSBURG KY
41129-8278
US

V. Phone/Fax

Practice location:
  • Phone: 606-408-0420
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number009560
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: