Individual
MISS CASEY S ROACH
Active
Individual
MISS CASEY S ROACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
005903
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005903
KENTUCKY BOARD OF PHYSICAL THERAPY
KY
Enumeration date
10/04/2011
Last updated
10/10/2018
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