Provider Demographics
NPI:1033261235
Name:HAMPTON PHYSICAL THERAPY,PSC
Entity Type:Organization
Organization Name:HAMPTON PHYSICAL THERAPY,PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CEI
Authorized Official - Prefix:
Authorized Official - First Name:CHERI
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:PT, MHS
Authorized Official - Phone:270-443-0681
Mailing Address - Street 1:5050 B VILLAGE SQUARE DR.
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42001
Mailing Address - Country:US
Mailing Address - Phone:270-443-0681
Mailing Address - Fax:270-442-7948
Practice Address - Street 1:5050 B VILLAGE SQUARE DR.
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001
Practice Address - Country:US
Practice Address - Phone:270-443-0681
Practice Address - Fax:270-442-7948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY5977Medicare ID - Type Unspecified
KY5977Medicare PIN