Provider Demographics
NPI:1487107785
Name:APPALACHIAN PHYSICAL THERAPY PLLC
Entity type:Organization
Organization Name:APPALACHIAN PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:N
Authorized Official - Last Name:BOWLING
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:606-672-6683
Mailing Address - Street 1:PO BOX 2121
Mailing Address - Street 2:
Mailing Address - City:HYDEN
Mailing Address - State:KY
Mailing Address - Zip Code:41749-2121
Mailing Address - Country:US
Mailing Address - Phone:606-672-6683
Mailing Address - Fax:606-672-6682
Practice Address - Street 1:21937 MAIN ST
Practice Address - Street 2:
Practice Address - City:HYDEN
Practice Address - State:KY
Practice Address - Zip Code:41749-8567
Practice Address - Country:US
Practice Address - Phone:606-672-6683
Practice Address - Fax:606-672-6682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-03
Last Update Date:2017-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY005735252Y00000X, 261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No252Y00000XAgenciesEarly Intervention Provider Agency