Provider Demographics
NPI:1700020989
Name:MCCOY, KRISTA ALLISON (PT)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:ALLISON
Last Name:MCCOY
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 1:474 WHIRLAWAY DR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40422-9037
Mailing Address - Country:US
Mailing Address - Phone:859-238-7650
Mailing Address - Fax:859-238-4160
Practice Address - Street 1:474 WHIRLAWAY DR
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422-9037
Practice Address - Country:US
Practice Address - Phone:859-238-7650
Practice Address - Fax:859-238-4160
Is Sole Proprietor?:No
Enumeration Date:2009-05-01
Last Update Date:2009-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY005322225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist