Julie A Mikesell

Individual provider Active NPI Physical Therapy Assistant · Jeffersontown, KY

NPI 1376741363 · NPPES record last updated Apr 20, 2009

Key facts

NPI
1376741363
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
PTA-0143 (KY)
Practice address
3500 Good Samaritan Way
Jeffersontown, KY 40299-6117
Phone
(502) 267-7403
Fax
(502) 266-9001
NPI assigned
Jul 11, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PTA-0143KYMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA-0143 KY Yes

Addresses

Primary practice location

3500 Good Samaritan Way
Jeffersontown, KY 40299-6117

Mailing address

3500 Good Samaritan Way
Jeffersontown, KY 40299-6117
Phone (502) 267-7403

Other providers in Jeffersontown, KY

All providers in Jeffersontown, KY · Physical Therapy Assistant in Kentucky

Sources for this page

Verify at the official NPI Registry.