Provider Demographics
NPI:1134572993
Name:GME ENTERPRISES PSC
Entity type:Organization
Organization Name:GME ENTERPRISES PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:E
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:740-398-3254
Mailing Address - Street 1:606 LANE ALLEN RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-3507
Mailing Address - Country:US
Mailing Address - Phone:740-398-3254
Mailing Address - Fax:
Practice Address - Street 1:1092 DUVAL ST
Practice Address - Street 2:SUITE 210
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40515-8908
Practice Address - Country:US
Practice Address - Phone:859-271-1092
Practice Address - Fax:888-521-2925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-18
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY005900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty