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General NPI Number Information
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NPI Number | 1558067280
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Entity Type | Individual
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Provider Name | HALEY PAULINE BERMAN PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 02/03/2023
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Last Update Date | 02/03/2023
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Provider Practice Location Address
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Address Line | 3600 CUMBERLAND AVE
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City | MIDDLESBORO
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State | KY
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Zip | 40965-2614
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Country | US
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Telephone | 606-242-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 90 CLEAR WATER RD
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City | GORDON
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State | KY
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Zip | 41819-9009
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Country | US
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Telephone | 606-303-4848
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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 | 008740
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License Number State | KY
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