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Organization

BEE ACTIVE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. AMBER NOEL HENDERSON PT,DPT (DOCTORATE OF PHYSICAL THERAPY)
(865) 809-2483
Entity
Organization

Contact information

Practice address
245 PLEASANT POINTE DR, LEXINGTON, KY 40517-4477
(865) 809-2483
(859) 268-8507
Mailing address
245 PLEASANT POINTE DR, LEXINGTON, KY 40517-4477
(865) 809-2483
(859) 268-8507

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT005482
KY
252Y00000X
Early Intervention Provider Agency
Primary
005482
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1245563428
INDIVIDUAL NPI
KY
Enumeration date
05/03/2010
Last updated
10/20/2010
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