Provider Demographics
NPI:1760493241
Name:TURNER, CAMELIA S (PT)
Entity Type:Individual
Prefix:
First Name:CAMELIA
Middle Name:S
Last Name:TURNER
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 1:72 MACK WALTERS RD
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40065-1738
Mailing Address - Country:US
Mailing Address - Phone:502-633-2443
Mailing Address - Fax:502-633-3126
Practice Address - Street 1:72 MACK WALTERS RD
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:KY
Practice Address - Zip Code:40065-1738
Practice Address - Country:US
Practice Address - Phone:502-633-2443
Practice Address - Fax:502-633-3126
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPT-000929225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY87900585OtherMEDICAID
KY1038570001Medicare NSC
KY0612406Medicare PIN