Provider Demographics
NPI:1669692042
Name:YOUR PHYSICAL THERAPY SOLUTIONS,LLC
Entity type:Organization
Organization Name:YOUR PHYSICAL THERAPY SOLUTIONS,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:M
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:270-689-2341
Mailing Address - Street 1:920 FREDERICA ST STE 104
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42301-3076
Mailing Address - Country:US
Mailing Address - Phone:270-689-2341
Mailing Address - Fax:270-689-2342
Practice Address - Street 1:920 FREDERICA ST STE 104
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301-3076
Practice Address - Country:US
Practice Address - Phone:270-689-2341
Practice Address - Fax:270-689-2342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY008857261QP2000X
KY003804225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty