Provider Demographics
NPI:1013687433
Name:PROOF LABORATORIES, LLC
Entity Type:Organization
Organization Name:PROOF LABORATORIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ELECTROPHYSIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PLOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT, ECS
Authorized Official - Phone:859-396-3460
Mailing Address - Street 1:208 TWIN SHORES CT
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40515-6403
Mailing Address - Country:US
Mailing Address - Phone:859-396-3460
Mailing Address - Fax:
Practice Address - Street 1:278 SOUTHLAND DR STE 150
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1954
Practice Address - Country:US
Practice Address - Phone:859-396-3460
Practice Address - Fax:949-561-5913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251E1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistElectrophysiology, ClinicalGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty