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Individual

KAREN YEVETT DECKARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
417 S 6TH ST, SUITE A, MAYFIELD, KY 42066-2328
(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
05
8700058400
KY
Enumeration date
09/06/2006
Last updated
03/03/2011
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