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General NPI Number Information
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NPI Number | 1215802921
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Entity Type | Organization
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Legal Business Name | PREMIER PHYSICAL THERAPY
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Dates
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Enumeration Date | 10/10/2025
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | 203 KENTUCKY AVE
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City | KEVIL
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State | KY
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Zip | 42053-8976
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Country | US
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Telephone | 270-462-8252
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Fax | 270-462-8253
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Provider Business Mailing Address
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Address Line | PO BOX 313
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City | KEVIL
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State | KY
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Zip | 42053-0313
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Country | US
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Telephone | 270-462-8252
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Fax | 270-462-8253
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Authorized Official
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Title or Position | PHYSICAL THERAPIST ASSISTANT
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Name | ALEXANDER J GRACE
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Credential |
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Telephone | 270-535-0493
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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