Organization Name: | ATLAS PHYSICAL THERAPY LLC |
NPI Number: | 1316310295 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BRYAN KRUEGER (CEO) |
Mailing Address: | 5050b Village Square Dr Paducah |
State: | KY US |
Postal Code: | 420019499 |
Phone Number: | 2704430681 |
Fax Number: | 2704427948 |
NPI Enumeration Date: | 11/02/2015 |
NPI Last Update Date: | 11/02/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2643 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |