MEDICARE: MRS. JULIE KEY MCKAY P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT001912	KY
2	174400000X	Specialist	PT001912	KY

General Provider Information

NPI Number	:	1891793493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JULIE KEY MCKAY P.T.

Provider Business Mailing Address
First Line	:	1925 OLD MAIN ST
Second Line	:	SUITE 1
City	:	MAYSVILLE
State	:	KY
Zip	:	41056-8984
Country	:	US
Telephone Number	:	606-759-4719
Fax Number	:

Provider Business Practice Location Address
First Line	:	1925 OLD MAIN ST
Second Line	:	SUITE 1
City	:	MAYSVILLE
State	:	KY
Zip	:	41056-8984
Country	:	US
Telephone Number	:	606-759-4719
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	05/04/2011

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