Organization
LIBERTY REHABILITATION PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FORREST L. WAIDE P. T. (PRESIDENT)
(270) 824-9227
Entity
Organization
Contact information
Practice address
100 YMCA DR, SUITE 5, MADISONVILLE, KY 42431-9000
(270) 824-9227
(270) 824-9206
Mailing address
100 YMCA DR, SUITE 5, MADISONVILLE, KY 42431-9000
(270) 824-9227
(270) 824-9206
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
001533
KY
Other
Enumeration date
10/11/2006
Last updated
05/13/2012
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