Organization
BLANFORD PEDIATRIC THERAPY LLC
Active
Other names
Partners in Pediatric Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LANCE PATRICK BLANFORD M.ED. (OWNER)
(859) 797-8223
Entity
Organization
Contact information
Practice address
704 BLOOMFIELD RD, BARDSTOWN, KY 40004-2025
(502) 331-5478
(502) 348-9825
Mailing address
704 BLOOMFIELD RD, BARDSTOWN, KY 40004-2025
(859) 797-8223
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
KY
225XP0200X
Pediatric Occupational Therapist
Primary
135224
KY
235Z00000X
Speech-Language Pathologist
140780
KY
252Y00000X
Early Intervention Provider Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50115322
PASSPORT HEALTH
KY
05
—
7100387750
—
KY
05
—
7100415400
—
KY
05
—
7100424590
—
KY
Enumeration date
01/09/2016
Last updated
01/12/2017
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