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General NPI Number Information
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NPI Number | 1871610402
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Entity Type | Organization
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Legal Business Name | CHRIST CENTERED PHYSICAL THERAPY FOR APPALACHIA INC.
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 12/14/2022
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Provider Practice Location Address
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Address Line | 133 HENDERSON CHURCH RD
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City | PINEVILLE
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State | KY
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Zip | 40977-9135
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Country | US
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Telephone | 606-269-9834
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Fax | 270-266-3757
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Provider Business Mailing Address
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Address Line | PO BOX 337
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City | FRAKES
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State | KY
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Zip | 40940-0337
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Country | US
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Telephone | 606-347-2398
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Fax | 606-337-8232
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. SAMANTHA MAIDEN
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Credential | P.T.
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Telephone | 606-347-2398
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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 | PT00001776
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License Number State | KY
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