Provider Demographics
NPI:1508923962
Name:GRAYBEAL, JOAN ELAINE (PT)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:ELAINE
Last Name:GRAYBEAL
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 1:800 CARDINAL POINT DR
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-8928
Mailing Address - Country:US
Mailing Address - Phone:270-296-9333
Mailing Address - Fax:
Practice Address - Street 1:800 CARDINAL POINT DR
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-8928
Practice Address - Country:US
Practice Address - Phone:270-296-9333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0016802251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1740OtherFIRST STEPS PROVIDER