Theresa Behan, ATC

Individual provider Active NPI Athletic Trainer · Edgewood, KY

NPI 1649650334 · NPPES record last updated Jun 8, 2015

Key facts

NPI
1649650334
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
AT146 (KY)
Practice address
830 Thomas More Pkwy
Edgewood, KY 41017-5102
Phone
(859) 344-4060
Fax
(859) 344-3629
NPI assigned
Jun 8, 2015
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

LicenseStateTypeSpecialty
AT146KYMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT146 KY Yes

Addresses

Primary practice location

830 Thomas More Pkwy
Edgewood, KY 41017-5102

Mailing address

830 Thomas More Pkwy
Edgewood, KY 41017-5102
Phone (859) 344-4060

Other providers in Edgewood, KY

All providers in Edgewood, KY · Athletic Trainer in Kentucky

Sources for this page

Verify at the official NPI Registry.