Provider Demographics
NPI:1932368172
Name:LAY, DINA C (PT)
Entity Type:Individual
Prefix:MRS
First Name:DINA
Middle Name:C
Last Name:LAY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 BOURNE AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42501-1915
Mailing Address - Country:US
Mailing Address - Phone:606-679-7421
Mailing Address - Fax:606-451-0344
Practice Address - Street 1:555 BOURNE AVE
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501-1915
Practice Address - Country:US
Practice Address - Phone:606-679-7421
Practice Address - Fax:606-451-0344
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY002828225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist