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General NPI Number Information
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NPI Number | 1922303882
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Entity Type | Organization
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Legal Business Name | MAYSVILLE PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 01/24/2011
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Last Update Date | 11/17/2014
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Provider Practice Location Address
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Address Line | 1925 OLD MAIN ST SUITE 1
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City | MAYSVILLE
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State | KY
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Zip | 41056-8984
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Country | US
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Telephone | 606-759-4719
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Fax |
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Provider Business Mailing Address
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Address Line | 1925 OLD MAIN ST SUITE 1
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City | MAYSVILLE
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State | KY
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Zip | 41056-8984
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Country | US
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Telephone | 606-759-4719
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JULIE KEY MCKAY
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Credential | P.T.
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Telephone | 606-759-4719
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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 | PT001912
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License Number State | KY
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