Healthcare Provider Details

I. General information

NPI: 1780021352
Provider Name (Legal Business Name): CAROLYN J COMBS PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2013
Last Update Date: 07/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 CUMBERLAND FALLS HWY STE C
CORBIN KY
40701-2739
US

IV. Provider business mailing address

2700 STANLEY GAULT PKWY STE 129
LOUISVILLE KY
40223-5176
US

V. Phone/Fax

Practice location:
  • Phone: 606-528-2149
  • Fax: 606-528-2338
Mailing address:
  • Phone: 502-253-4914
  • Fax: 502-489-5751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT-005162
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: