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General NPI Number Information
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NPI Number | 1366442105
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Entity Type | Organization
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Legal Business Name | PHYSICAL MEDICINE SERVICES, INC.
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Dates
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Enumeration Date | 07/22/2005
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Last Update Date | 10/28/2010
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Provider Practice Location Address
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Address Line | 732 VINE ST
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City | MURRAY
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State | KY
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Zip | 42071-2630
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Country | US
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Telephone | 270-753-6477
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Fax | 270-753-6478
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Provider Business Mailing Address
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Address Line | 732 VINE ST
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City | MURRAY
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State | KY
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Zip | 42071-2630
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Country | US
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Telephone | 270-753-6477
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Fax | 270-753-6478
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | MR. SCOTT ROBERT WINKLER
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Credential | PT, DPT
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Telephone | 270-753-6477
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | KY001536
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License Number State | KY
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