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General NPI Number Information
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NPI Number | 1912709213
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Entity Type | Organization
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Legal Business Name | NORTHERN KENTUCKY PHYSIOTHERAPY
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Dates
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Enumeration Date | 03/26/2025
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 1521 CAVALRY LN STE 201
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City | FLORENCE
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State | KY
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Zip | 41042-3576
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Country | US
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Telephone | 859-322-8816
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Fax |
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Provider Business Mailing Address
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Address Line | 2216 ELIAS BOONE CT
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City | HEBRON
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State | KY
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Zip | 41048-2005
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Country | US
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Telephone | 859-322-8816
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | KEATON HAGINS
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Credential | PT, DPT
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Telephone | 859-322-8816
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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 |
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License Number State |
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