Individual
HALEY SCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
944 FIELDS DR, 102, BOWLING GREEN, KY 42104-5341
(270) 495-1312
Mailing address
209 SALEM LN, FRANKLIN, KY 42134-9541
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A03490
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A03490
PTA
KY
Enumeration date
03/23/2017
Last updated
04/02/2019
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