Healthcare Provider Details

I. General information

NPI: 1285814145
Provider Name (Legal Business Name): BETH UNDERWOOD COON PT, DPT, CHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2007
Last Update Date: 04/24/2023
Certification Date: 04/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 MARSAILLES RD
VERSAILLES KY
40383-1911
US

IV. Provider business mailing address

1650 LYNDON FARM CT STE 300
LOUISVILLE KY
40223-5005
US

V. Phone/Fax

Practice location:
  • Phone: 859-879-3560
  • Fax: 859-879-3564
Mailing address:
  • Phone: 502-882-9379
  • Fax: 502-805-0526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number002242
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code2251H1200X
TaxonomyHand Physical Therapist
License Number002242
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: