Organization
WAIDE PHYSICAL THERAPY PSC
Active
Organization
WAIDE PHYSICAL THERAPY PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FORREST WAIDE PT (PRESIDENT / CEO)
(270) 871-7503
Entity
Organization
Contact information
Practice address
2228 ANTON RD, MADISONVILLE, KY 42431-7700
(270) 399-1776
(270) 440-2007
Mailing address
2228 ANTON RD, MADISONVILLE, KY 42431-7700
(270) 399-1776
(270) 440-2007
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
001533
KY
2251H1200X
Hand Physical Therapist
10011030054
KY
2251X0800X
Orthopedic Physical Therapist
1320
KY
Other
Enumeration date
03/12/2017
Last updated
03/12/2017
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