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General NPI Number Information
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NPI Number | 1447024237
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Entity Type | Individual
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Provider Name | FRANCES ALEXIS TILLERY PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 11/13/2023
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Last Update Date | 11/13/2023
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Provider Practice Location Address
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Address Line | 193 GLADES RD
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City | BEREA
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State | KY
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Zip | 40403-2261
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Country | US
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Telephone | 859-986-1055
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 932184
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City | ATLANTA
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State | GA
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Zip | 31193-2184
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Country | US
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Telephone | 800-699-9395
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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 | 008974
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License Number State | KY
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