Organization
SMITHS GROVE PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEREMY LOGAN SCHAFER PT, OCS, ECS (OWNER/MEMBER)
(270) 563-2084
Entity
Organization
Contact information
Practice address
111 COLLEGE STREET, SMITHS GROVE, KY 42171
(270) 563-2084
(270) 563-2085
Mailing address
PO BOX 157, BROWNSVILLE, KY 42210-0157
(270) 563-2084
(270) 563-2085
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
004222
KY
2251E1300X
Clinical Electrophysiology Physical Therapist
004222
KY
2251S0007X
Sports Physical Therapist
004222
KY
2251X0800X
Orthopedic Physical Therapist
004222
KY
Other
Enumeration date
06/18/2009
Last updated
02/16/2010
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