Provider Demographics
NPI:1154991875
Name:WOODFORD KIDS PEDIATRIC THERAPY PLLC
Entity type:Organization
Organization Name:WOODFORD KIDS PEDIATRIC THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GINTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-753-2083
Mailing Address - Street 1:205 FRANKFORT ST STE 3
Mailing Address - Street 2:
Mailing Address - City:VERSAILLES
Mailing Address - State:KY
Mailing Address - Zip Code:40383-1023
Mailing Address - Country:US
Mailing Address - Phone:859-753-2083
Mailing Address - Fax:
Practice Address - Street 1:205 FRANKFORT ST STE 3
Practice Address - Street 2:
Practice Address - City:VERSAILLES
Practice Address - State:KY
Practice Address - Zip Code:40383-1023
Practice Address - Country:US
Practice Address - Phone:859-753-2083
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-25
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty