Provider Demographics
NPI:1093999716
Name:DRAYER PHYSICAL THERAPY INSTITUTE OF KENTUCKY PLLC
Entity Type:Organization
Organization Name:DRAYER PHYSICAL THERAPY INSTITUTE OF KENTUCKY PLLC
Other - Org Name:
Other - Org Type:
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:PT
Authorized Official - Phone:717-220-2100
Mailing Address - Street 1:1054 CENTER DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-3851
Mailing Address - Country:US
Mailing Address - Phone:859-625-0600
Mailing Address - Fax:859-625-0969
Practice Address - Street 1:1054 CENTER DR
Practice Address - Street 2:SUITE 1
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-3851
Practice Address - Country:US
Practice Address - Phone:859-625-0600
Practice Address - Fax:859-625-0969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-18
Last Update Date:2012-04-09
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
KY00547Medicare PIN