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Individual

BETH UNDERWOOD COON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT, DPT, CHT

Contact information

Practice address
535 MARSAILLES RD, VERSAILLES, KY 40383-1911
(859) 879-3560
(859) 879-3564
Mailing address
1650 LYNDON FARM CT STE 300, LOUISVILLE, KY 40223-5005
(502) 882-9379
(502) 805-0526

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
002242
KY
2251H1200X
Hand Physical Therapist
002242
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000540474
BCBS
KY
01
20-4579943
HUMANA
KY
01
611938100
US DEPT OF LABOR WC
KY
01
7311873
AETNA
KY
Enumeration date
11/08/2007
Last updated
04/24/2023
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