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Organization

KAREN DECKARD THERACARE PHYSICAL THERAPY

Active
Other names
THERACARE PHYSICAL THERAPY
Organization subpart
No

Provider details

NPI number
Authorized official
MS. KAREN YEVETT DECKARD PT (PT OWNER)
(270) 251-3590
Entity
Organization

Contact information

Practice address
1111 MEDICAL CENTER CIR, MAYFIELD, KY 42066-1194
(270) 251-3590
(270) 251-3586
Mailing address
PO BOX 187, MAYFIELD, KY 42066-0015
(270) 251-3590
(270) 251-3586

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
002616
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000067871
ANTHEM BCBS
KY
01
1437252756
NPI INDIVIDUAL
KY
05
8700058400
KY
01
DE5082
RR MEDICARE GROUP
KY
01
P00297296
RR MEDICARE INDIVIDUAL
KY
Enumeration date
11/30/2006
Last updated
07/28/2008
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