Individual
DEIDRA BREITENBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
321 S 3RD ST, DANVILLE, KY 40422-2090
(859) 236-7012
(859) 236-7407
Mailing address
321 S 3RD ST, DANVILLE, KY 40422-2090
(859) 236-7012
(859) 236-7407
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
002215
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
87001574
—
KY
Enumeration date
11/01/2005
Last updated
08/04/2015
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