Organization
LEGACY PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW MATTINGLY MPT (OWNER)
(859) 229-2203
Entity
Organization
Contact information
Practice address
237 E HIGHWAY 60, HARDINSBURG, KY 40143-4892
(859) 229-2203
Mailing address
237 E HIGHWAY 60, HARDINSBURG, KY 40143-4892
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1639165210
BCBS
KY
05
—
1639165210
—
KY
Enumeration date
01/16/2020
Last updated
06/30/2021
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