Provider Demographics
NPI:1003946229
Name:FINK, DAWNE M (PTA)
Entity Type:Individual
Prefix:
First Name:DAWNE
Middle Name:M
Last Name:FINK
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 CROSBY DR APT 2201
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40515-1807
Mailing Address - Country:US
Mailing Address - Phone:859-992-6167
Mailing Address - Fax:
Practice Address - Street 1:127 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:CYNTHIANA
Practice Address - State:KY
Practice Address - Zip Code:41031-3801
Practice Address - Country:US
Practice Address - Phone:859-234-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225200000X
KYA00981225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY9503Medicare ID - Type UnspecifiedPART B GROUP NUMBER