Ila Corder, PTA
Individual provider Active NPI Physical Therapy Assistant · Williamsburg, KY
NPI 1265830657 · NPPES record last updated Dec 17, 2014
Key facts
- NPI
- 1265830657
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- AO1314 (KY)
- Practice address
- 368 Penny LN
Williamsburg, KY 40769-7481 - Phone
- (606) 549-0886
- Fax
- (606) 549-2665
- NPI assigned
- Dec 17, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AO1314 | KY | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | AO1314 | KY | Yes |
Addresses
Primary practice location
368 Penny LN
Williamsburg, KY 40769-7481
Mailing address
368 Penny LN
Williamsburg, KY 40769-7481
Phone (606) 549-0886
Other providers in Williamsburg, KY
- Rebekah Virginia Elaine Cloud
- Sarah Patricia Cloud
- Jacey Cooper
- Robert Wayne Cooper
- Corbin Cardiology & Internal Medicine, Inc.
- Corner Prescription Shoppe Inc
- Michael C Culver
- Cumberland Family Medical Center, Inc.
- Cumberland Foot and Ankle Center
- Cumberland Mountain Behavioral Health
All providers in Williamsburg, KY · Physical Therapy Assistant in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 17, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.