Individual
ILA CORDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
368 PENNY LN, WILLIAMSBURG, KY 40769-7481
(606) 549-0886
(606) 549-2665
Mailing address
368 PENNY LN, WILLIAMSBURG, KY 40769-7481
(606) 549-0886
(606) 549-2665
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AO1314
KY
Other
Enumeration date
12/17/2014
Last updated
12/17/2014
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