Provider Demographics
NPI:1689747719
Name:CENTRAL KENTUCKY THERAPY SERVICES, PLLC
Entity Type:Organization
Organization Name:CENTRAL KENTUCKY THERAPY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALOYSIUS
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:MEIVES
Authorized Official - Suffix:IV
Authorized Official - Credentials:PHYSICAL THERAPIST
Authorized Official - Phone:606-693-9644
Mailing Address - Street 1:100 HIGHWAY 15 S STE 136
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:KY
Mailing Address - Zip Code:41339-8636
Mailing Address - Country:US
Mailing Address - Phone:606-693-9644
Mailing Address - Fax:606-693-9643
Practice Address - Street 1:100 HIGHWAY 15 S STE 136
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:KY
Practice Address - Zip Code:41339-8636
Practice Address - Country:US
Practice Address - Phone:606-693-9644
Practice Address - Fax:606-693-9643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4191261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7876Medicare ID - Type UnspecifiedCLINIC NUMBER