Healthcare Provider Details

I. General information

NPI: 1245237205
Provider Name (Legal Business Name): BARBARA ANN KUTYNSKY MSPT
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/06/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3217 SUMMIT SQUARE PL SUITE 100
LEXINGTON KY
40509-2636
US

IV. Provider business mailing address

3217 SUMMIT SQUARE PL SUITE 100
LEXINGTON KY
40509-2636
US

V. Phone/Fax

Practice location:
  • Phone: 859-263-8080
  • Fax: 859-263-8775
Mailing address:
  • Phone: 859-263-8080
  • Fax: 859-263-8775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number004099
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: