Individual
MR. SHAUN GOULBOURNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICAL THERAPIST
Contact information
Practice address
1485 S DIXIE ST, HORSE CAVE, KY 42749-1457
(270) 786-4551
(270) 786-4551
Mailing address
PO BOX 911148, LEXINGTON, KY 40591-1148
(859) 278-2121
(859) 276-1649
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
002839
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
87001731
—
KY
Enumeration date
03/07/2007
Last updated
07/08/2007
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