Individual
DORIS R. BANKSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2625 LEGENDS WAY, CRESTVIEW HILLS, KY 41017-4300
(859) 331-5951
Mailing address
2222 SULLIVAN TRL, EASTON, PA 18040-7958
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A01663
KY
Other
Enumeration date
07/10/2007
Last updated
07/10/2007
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