Individual
MRS. DEBORAH BRYANT HATHERILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
428 2ND ST, PAINTSVILLE, KY 41240
(606) 789-5846
(606) 789-5876
Mailing address
428 2ND ST, PAINTSVILLE, KY 41240
(606) 789-5846
(606) 789-5876
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
000573
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000068657
ANTHEM
—
01
—
2162
CHA
—
01
—
650015612
RAILROAD MEDICARE
—
Enumeration date
05/19/2006
Last updated
11/15/2011
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