Provider Demographics
NPI:1467174409
Name:CULVER, ZACHARY LYNN (PT)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:LYNN
Last Name:CULVER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 SCENIC DR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40769-1827
Mailing Address - Country:US
Mailing Address - Phone:606-304-1301
Mailing Address - Fax:
Practice Address - Street 1:100 LONDON MOUNTAIN VIEW DR STE 400
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741-6669
Practice Address - Country:US
Practice Address - Phone:606-330-0513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-15
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYTP2022074225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist