Provider Demographics
NPI:1679820856
Name:SPAULDING PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:SPAULDING PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLYN
Authorized Official - Middle Name:HENDERSON
Authorized Official - Last Name:SPAULDING
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:859-229-5101
Mailing Address - Street 1:3041 OWINGSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MT STERLING
Mailing Address - State:KY
Mailing Address - Zip Code:40353-9003
Mailing Address - Country:US
Mailing Address - Phone:859-229-5101
Mailing Address - Fax:859-497-2926
Practice Address - Street 1:3041 OWINGSVILLE RD
Practice Address - Street 2:
Practice Address - City:MT STERLING
Practice Address - State:KY
Practice Address - Zip Code:40353-9003
Practice Address - Country:US
Practice Address - Phone:859-229-5101
Practice Address - Fax:859-497-2926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-07
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY002437225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty