Provider Demographics
NPI:1578345393
Name:IRONTON PHYSCIAL THERAPY INC
Entity Type:Organization
Organization Name:IRONTON PHYSCIAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING AGENT, BILLING DIRECT
Authorized Official - Prefix:
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:SHAE
Authorized Official - Last Name:RITCHEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-324-0540
Mailing Address - Street 1:1212 BATH AVE STE 350
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-3685
Mailing Address - Country:US
Mailing Address - Phone:606-324-0540
Mailing Address - Fax:606-324-0616
Practice Address - Street 1:830 3RD ST, ATHLETIC CENTER ROOM 138
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662
Practice Address - Country:US
Practice Address - Phone:740-529-7760
Practice Address - Fax:606-324-0616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty