Healthcare Provider Details

I. General information

NPI: 1811106305
Provider Name (Legal Business Name): ADRIAN COURTNEY BANTON PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 BROOKHAVEN RD STE 201
FRANKLIN KY
42134-2746
US

IV. Provider business mailing address

332 MONTEREY RD
FRANKLIN KY
42134-9119
US

V. Phone/Fax

Practice location:
  • Phone: 270-598-4935
  • Fax: 270-586-6313
Mailing address:
  • Phone: 270-776-3984
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251E1200X
TaxonomyErgonomics Physical Therapist
License Number004514
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number004514
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number004514
License Number StateKY
# 4
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number004514
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: