Healthcare Provider Details

I. General information

NPI: 1467585174
Provider Name (Legal Business Name): KENTUCKY HAND & PHYSICAL THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 02/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3050 HARRODSBURG RD SUITE 204
LEXINGTON KY
40503-2747
US

IV. Provider business mailing address

3050 HARRODSBURG RD SUITE 204
LEXINGTON KY
40503-2747
US

V. Phone/Fax

Practice location:
  • Phone: 859-296-1696
  • Fax: 859-296-1676
Mailing address:
  • Phone: 859-296-1696
  • Fax: 859-296-1676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPT004841
License Number StateKY

VIII. Authorized Official

Name: BRIDGET E MCGOVERN
Title or Position: PRACTICE ADMINISTRATOR
Credential: MBA, CPC
Phone: 859-264-8866