=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740387786
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PT PROS, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/20/2006
-----------------------------------------------------
Last Update Date | 10/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 110 PROFESSIONAL LN SUITE 102
-----------------------------------------------------
City | HARLAN
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40831
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 606-573-9539
-----------------------------------------------------
Fax | 606-573-7390
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 383 CORBIN CENTER DR
-----------------------------------------------------
City | CORBIN
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40701-1895
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 606-526-2909
-----------------------------------------------------
Fax | 606-526-2901
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | CONNIE D. HAUSER
-----------------------------------------------------
Credential | PT
-----------------------------------------------------
Telephone | 606-526-2918
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------