Individual
MR. SAMUEL JEFFERY AYRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
4010 DUPONT CIRCLE, SUITE L-14, LOUISVILLE, KY 40207-4825
(502) 899-1911
(502) 899-1981
Mailing address
4010 DUPONT CIRCLE, SUITE L14, LOUISVILLE, KY 40207-4825
(502) 899-1911
(502) 899-1981
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
000996
KY
2251X0800X
Orthopedic Physical Therapist
996
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
650019854
RAILROAD MEDICARE
KY
Enumeration date
06/08/2006
Last updated
11/22/2011
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