Individual
MARY UNDERWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1096 WELLINGTON WAY STE 110, LEXINGTON, KY 40513-1200
(850) 303-6393
Mailing address
2109 PALOMAR TRACE DR, LEXINGTON, KY 40513-1120
(859) 492-2063
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A04134
KY
Other
Enumeration date
09/19/2020
Last updated
09/19/2020
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