Provider Demographics
NPI:1336911635
Name:ABLE, AUTUMN (DPT)
Entity Type:Individual
Prefix:
First Name:AUTUMN
Middle Name:
Last Name:ABLE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:AUTUMN
Other - Middle Name:
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:515 LEE CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-7531
Mailing Address - Country:US
Mailing Address - Phone:502-682-5527
Mailing Address - Fax:
Practice Address - Street 1:400 FARRIS PARKS BLVD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-7650
Practice Address - Country:US
Practice Address - Phone:859-353-3666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist