Individual
JASON WADDLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
101 EASTSIDE DR STE D, GEORGETOWN, KY 40324-8763
(502) 867-0111
Mailing address
1132 JONESTOWN LN, LEXINGTON, KY 40517-2996
(859) 447-0620
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
TP2019119
KY
Other
Enumeration date
09/13/2019
Last updated
09/13/2019
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