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General NPI Number Information
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NPI Number | 1073303863
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Entity Type | Individual
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Provider Name | COLBY BLAKE SPENCER PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 05/07/2025
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 175 WEDDINGTON BRANCH RD
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City | PIKEVILLE
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State | KY
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Zip | 41501-3204
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Country | US
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Telephone | 606-637-1830
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Fax |
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Provider Business Mailing Address
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Address Line | 125 JARRELL BRANCH RD
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City | DANA
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State | KY
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Zip | 41615-9045
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Country | US
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Telephone | 606-424-7818
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 009310
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License Number State | KY
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