Organization
FULL RANGE EARLY INTERVENTION SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KASEY MARIE BOSWELL PT, DPT (OWNER)
(502) 550-0639
Entity
Organization
Contact information
Practice address
11206 PEBBLE TRCE, LOUISVILLE, KY 40229-2788
(502) 550-0639
Mailing address
11206 PEBBLE TRCE, LOUISVILLE, KY 40229-2788
(502) 550-0639
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
01/20/2023
Last updated
03/05/2023
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