Provider Demographics
NPI:1740242015
Name:DRAYER PHYSICAL THERAPY INSTITUTE OF KENTUCKY PLLC
Entity Type:Organization
Organization Name:DRAYER PHYSICAL THERAPY INSTITUTE OF KENTUCKY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LUKE
Authorized Official - Middle Name:
Authorized Official - Last Name:DRAYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-220-2100
Mailing Address - Street 1:600 PERIMETER DR
Mailing Address - Street 2:SUITE 175
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40517-4119
Mailing Address - Country:US
Mailing Address - Phone:859-268-1201
Mailing Address - Fax:859-268-1202
Practice Address - Street 1:600 PERIMETER DR
Practice Address - Street 2:SUITE 175
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40517-4119
Practice Address - Country:US
Practice Address - Phone:859-268-1201
Practice Address - Fax:859-268-1202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-04
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY9196Medicare PIN