Healthcare Provider Details

I. General information

NPI: 1114333994
Provider Name (Legal Business Name): ASSOCIATES IN PEDIATRIC THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2014
Last Update Date: 03/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

194 N LIMESTONE
LEXINGTON KY
40507-1121
US

IV. Provider business mailing address

90 HOWARD DR
SHELBYVILLE KY
40065-8138
US

V. Phone/Fax

Practice location:
  • Phone: 859-899-2022
  • Fax: 502-805-1511
Mailing address:
  • Phone: 502-633-1007
  • Fax: 502-805-1511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: JEANNE BURNETT
Title or Position: OFFICE MANAGER
Credential:
Phone: 502-633-1007