| Organization Name: | LIBERTY REHABILITATION PSC |
| NPI Number: | 1023306669 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | FORREST L WAIDE (DIRECTOR) |
| Mailing Address: | 378 Us Highway 62 W Princeton |
| State: | KY US |
| Postal Code: | 424452405 |
| Phone Number: | 2703651420 |
| Fax Number: | 2703651425 |
| NPI Enumeration Date: | 07/18/2011 |
| NPI Last Update Date: | 07/18/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251H1200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Hand |
| Taxonomy Definition: | |