Organization
ORTHOPEDIC & SPORTS PHYSICAL THERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN D MCGOVERN (OFFICE MANAGER)
(502) 426-2221
Entity
Organization
Contact information
Practice address
1868 PLAUDIT PLACE, SUITE B, LEXINGTON, KY 40509
(859) 264-0512
Mailing address
1868 PLAUDIT PLACE, SUITE B, LEXINGTON, KY 40509
(859) 264-0512
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100159410
—
KY
Enumeration date
04/12/2012
Last updated
09/25/2012
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