Provider Demographics
NPI:1568790723
Name:STORY PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:STORY PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:BARKER
Authorized Official - Last Name:STORY
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:270-408-1324
Mailing Address - Street 1:125 S 20TH ST
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42001-7100
Mailing Address - Country:US
Mailing Address - Phone:270-408-1324
Mailing Address - Fax:270-408-1325
Practice Address - Street 1:125 S 20TH ST
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-7100
Practice Address - Country:US
Practice Address - Phone:270-408-1324
Practice Address - Fax:270-408-1325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-30
Last Update Date:2009-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY003779225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
5031801Medicare PIN