Organization
SUMMIT PHYSICAL THERAPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON A GOUMAS PT (MANAGING MEMBER)
(859) 737-3994
Entity
Organization
Contact information
Practice address
126 PROFESSIONAL AVE, WINCHESTER, KY 40391-1116
(859) 737-3994
(859) 737-3223
Mailing address
126 PROFESSIONAL AVE, WINCHESTER, KY 40391-1116
(859) 737-3994
(859) 737-3223
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
87900643
—
KY
Enumeration date
05/23/2006
Last updated
03/07/2008
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