Organization
CHANGE OF PACE PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY S. CUMMINGS PT (OWNER)
(270) 231-6868
Entity
Organization
Contact information
Practice address
725 HARVARD DR, OWENSBORO, KY 42301-6185
(270) 231-6868
Mailing address
PO BOX 298, UTICA, KY 42376-0298
(270) 231-6868
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100725450
—
KY
Enumeration date
12/08/2020
Last updated
03/24/2021
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