Provider Demographics
NPI:1235448846
Name:CASTLE, LUCINDA T (PT)
Entity Type:Individual
Prefix:
First Name:LUCINDA
Middle Name:T
Last Name:CASTLE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 GREENUP AVE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-1953
Mailing Address - Country:US
Mailing Address - Phone:606-324-0540
Mailing Address - Fax:606-324-0616
Practice Address - Street 1:2700 GREENUP AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-1953
Practice Address - Country:US
Practice Address - Phone:606-324-1844
Practice Address - Fax:606-324-1877
Is Sole Proprietor?:No
Enumeration Date:2010-09-30
Last Update Date:2011-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPT005684225100000X
WVPT 002929225100000X
OHPT 013081225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP400027216Medicare PIN
OH4304221Medicare PIN