Provider Demographics
NPI:1932419348
Name:DRAYER PHYSICAL THERAPY INSTITUTE OF KY PLLC
Entity Type:Organization
Organization Name:DRAYER PHYSICAL THERAPY INSTITUTE OF KY PLLC
Other - Org Name:DRAYER PHYSICAL THERAPY INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LUKE
Authorized Official - Middle Name:A
Authorized Official - Last Name:DRAYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-220-2100
Mailing Address - Street 1:1219 W SPRING ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:GA
Mailing Address - Zip Code:30655-1756
Mailing Address - Country:US
Mailing Address - Phone:770-207-6624
Mailing Address - Fax:770-207-6631
Practice Address - Street 1:1219 W SPRING ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:GA
Practice Address - Zip Code:30655-1756
Practice Address - Country:US
Practice Address - Phone:770-207-6624
Practice Address - Fax:770-207-6631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-19
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty