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General NPI Number Information
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NPI Number | 1598060626
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Entity Type | Organization
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Legal Business Name | PT PRACTICES
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Dates
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Enumeration Date | 01/20/2011
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Last Update Date | 01/20/2011
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Provider Practice Location Address
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Address Line | 63 SAINT JOHN CHURCH RD
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-8750
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Country | US
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Telephone | 270-766-2484
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 175
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City | RINEYVILLE
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State | KY
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Zip | 40162-0175
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Country | US
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Telephone | 270-766-2484
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST/OWNER
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Name | MRS. MICHELLE LEIGH HIGDON
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Credential | PT, DPT
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Telephone | 270-766-2484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 004901
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License Number State | KY
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