Provider Demographics
NPI:1740699651
Name:LU-GARRIGAN, JAYME-KHANH Y (DPT)
Entity type:Individual
Prefix:MRS
First Name:JAYME-KHANH
Middle Name:Y
Last Name:LU-GARRIGAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MISS
Other - First Name:JAYME
Other - Middle Name:
Other - Last Name:LU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:403 N MILES ST
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-1834
Mailing Address - Country:US
Mailing Address - Phone:270-360-9129
Mailing Address - Fax:270-234-8197
Practice Address - Street 1:1222 WOODLAND DR
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-2710
Practice Address - Country:US
Practice Address - Phone:270-234-1569
Practice Address - Fax:270-234-0680
Is Sole Proprietor?:No
Enumeration Date:2014-08-05
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY006331225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist