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Individual

JEFFREY ALLEN METCALF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
11902 OAK BAY PL, LOUISVILLE, KY 40245-6476
(502) 550-2525
Mailing address
11902 OAK BAY PL, LOUISVILLE, KY 40245-6476
(502) 550-2525

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AO1945
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3670
4628
KY
05
3670
KY
Enumeration date
08/18/2011
Last updated
08/18/2011
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