Organization
TACKETT PHYSICAL THERAPY PLLC
Active
Other names
ReActivate Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
TRENT TACKETT PT, DPT (OWNER/PHYSICAL THERAPIST)
(606) 207-5248
Entity
Organization
Contact information
Practice address
102 W MADISON ST, LA GRANGE, KY 40031-1428
(606) 207-5248
Mailing address
102 W MADISON ST, LA GRANGE, KY 40031-1428
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
03/11/2024
Last updated
03/11/2024
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