Individual
PATRICIA ANN GREGORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
9108 HIGHWAY 401, CUSTER, KY 40115-5008
(270) 735-2838
Mailing address
9108 HIGHWAY 401, CUSTER, KY 40115-5008
(270) 735-2838
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
A02901
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A02901
PTA LICENSE
KY
Enumeration date
04/12/2018
Last updated
04/12/2018
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