Healthcare Provider Details

I. General information

NPI: 1467174409
Provider Name (Legal Business Name): ZACHARY LYNN CULVER PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2022
Last Update Date: 09/15/2022
Certification Date: 09/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 LONDON MOUNTAIN VIEW DR STE 400
LONDON KY
40741-6669
US

IV. Provider business mailing address

178 SCENIC DR
WILLIAMSBURG KY
40769-1827
US

V. Phone/Fax

Practice location:
  • Phone: 606-330-0513
  • Fax:
Mailing address:
  • Phone: 606-304-1301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberTP2022074
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: