Provider Demographics
NPI:1104136514
Name:DRAYER PHYSICAL THERAPY INSTITUTE OF KY PLLC
Entity type:Organization
Organization Name:DRAYER PHYSICAL THERAPY INSTITUTE OF KY PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
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 1:4000 SHAKERAG HL
Mailing Address - Street 2:STE 100
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-4047
Mailing Address - Country:US
Mailing Address - Phone:770-692-9460
Mailing Address - Fax:770-692-9461
Practice Address - Street 1:4000 SHAKERAG HL
Practice Address - Street 2:STE 100
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-4047
Practice Address - Country:US
Practice Address - Phone:770-692-9460
Practice Address - Fax:770-692-9461
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 - Single Specialty