Organization
VISIONARY THERAPY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BYRON SCOTT JOHNSTON CCC-SLP (PRESIDENT)
(859) 229-4151
Entity
Organization
Contact information
Practice address
100 KY HWY 15 SOUTH, SUITE 136, JACKSON, KY 40475
(859) 229-4151
Mailing address
100 KY HWY 15 SOUTH, SUITE 136, JACKSON, KY 40475
(859) 229-4151
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
01/18/2019
Last updated
01/29/2021
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