Organization
LOKI INC
Active
Other names
East Kentucky Physiotherapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FRANKLIN STUMBO CSCS (OWNER/PHYSICAL THERAPIST)
(606) 478-1111
Entity
Organization
Contact information
Practice address
10824 US 23 SOUTH, SUITE 102, BETSY LAYNE, KY 41605
(606) 478-1111
(606) 478-1113
Mailing address
P.O. BOX 68, BETSY LAYNE, KY 41605
(606) 478-1111
(606) 478-1113
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
003789
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8700057600
—
KY
Enumeration date
06/10/2015
Last updated
06/10/2015
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