Organization
MAX PERFORMANCE PHYSICAL THERAPY AND SPORTS REHAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ALICE CREQUE MSPT (DIRECTOR OWNER)
(502) 647-0133
Entity
Organization
Contact information
Practice address
141 STONECREST RD, UNIT 2, SHELBYVILLE, KY 40065
(502) 647-0133
(502) 647-0138
Mailing address
141 STONECREST RD, UNIT 2, SHELBYVILLE, KY 40065-8166
(502) 647-0133
(502) 647-0138
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
004464
KY
Other
Enumeration date
12/15/2006
Last updated
08/22/2020
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