Healthcare Provider Details

I. General information

NPI: 1922440353
Provider Name (Legal Business Name): DRAYER PHYSICAL THERAPY KENTUCKY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2013
Last Update Date: 03/03/2020
Certification Date: 03/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

651 PERIMETER DR STE 110
LEXINGTON KY
40517-4348
US

IV. Provider business mailing address

1200 CORPORATE DR STE 400
BIRMINGHAM AL
35242-5424
US

V. Phone/Fax

Practice location:
  • Phone: 859-268-1201
  • Fax: 859-268-1202
Mailing address:
  • Phone: 717-839-2125
  • Fax: 717-565-1104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: LISA BENETTO
Title or Position: MANAGER
Credential:
Phone: 423-238-8923