Individual
MIRANDA ELLEN INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2117 ROCKY DR, PARIS, KY 40361-1370
(859) 988-5005
Mailing address
123 WESTRIDGE LN, PARIS, KY 40361-2483
(859) 435-5325
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A04124
KY
Other
Enumeration date
04/10/2021
Last updated
04/10/2021
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