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General NPI Number Information
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NPI Number | 1275963225
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Entity Type | Individual
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Provider Name | MICHELLE MAYFIELD PT
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Gender | Female
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Dates
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Enumeration Date | 11/12/2013
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Last Update Date | 03/02/2016
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Provider Practice Location Address
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Address Line | 230 FOUNTAIN CT SUITE 325
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City | LEXINGTON
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State | KY
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Zip | 40509-1895
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Country | US
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Telephone | 859-263-0595
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Fax | 859-263-0385
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Provider Business Mailing Address
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Address Line | PO BOX 950248
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City | LOUISVILLE
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State | KY
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Zip | 40295-0248
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Country | US
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Telephone | 502-489-5730
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Fax | 502-489-5753
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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 | PT-006338
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License Number State | KY
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