Healthcare Provider Details
I. General information
NPI: 1639059017
Provider Name (Legal Business Name): HYPHEN HQ
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/05/2025
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
543 BOONESBORO AVE
LEXINGTON KY
40508-1953
US
IV. Provider business mailing address
543 BOONESBORO AVE
LEXINGTON KY
40508-1953
US
V. Phone/Fax
- Phone: 502-427-6004
- Fax:
- Phone: 502-427-6004
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2251G0304X |
| Taxonomy | Geriatric Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RICKARD
DUSTIN
JONES
Title or Position: PT/CEO
Credential: PT, DPT
Phone: 502-427-6004