Provider Demographics
NPI:1073897971
Name:DRAYER PHYSICAL THERAPY INSTITUTE LLC
Entity Type:Organization
Organization Name:DRAYER PHYSICAL THERAPY INSTITUTE LLC
Other - Org Name:KENTUCKY HAND - RICHMOND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LUKE
Authorized Official - Middle Name:A
Authorized Official - Last Name:DRAYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-220-2100
Mailing Address - Street 1:837 EASTERN BYP
Mailing Address - Street 2:SUITE A
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-2569
Mailing Address - Country:US
Mailing Address - Phone:859-625-5564
Mailing Address - Fax:859-625-1323
Practice Address - Street 1:837 EASTERN BYP
Practice Address - Street 2:SUITE A
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-2569
Practice Address - Country:US
Practice Address - Phone:859-625-5564
Practice Address - Fax:859-625-1323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-11
Last Update Date:2014-02-20
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
KY6611590003OtherNSC PTAN
KY6611590003OtherNSC PTAN