Healthcare Provider Details

I. General information

NPI: 1467643064
Provider Name (Legal Business Name): JAMES ERIC ESCALONI PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2007
Last Update Date: 05/31/2024
Certification Date: 05/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 N EAGLE CREEK DR
LEXINGTON KY
40509-1806
US

IV. Provider business mailing address

101 N EAGLE CREEK DR
LEXINGTON KY
40509-1806
US

V. Phone/Fax

Practice location:
  • Phone: 859-275-4878
  • Fax: 859-276-5400
Mailing address:
  • Phone: 859-275-4878
  • Fax: 859-275-5400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5176
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: