Mary Pat Gravil, PTA
Individual provider Active NPI Physical Therapy Assistant · Bonnieville, KY
NPI 1992963516 · NPPES record last updated May 30, 2008
Key facts
- NPI
- 1992963516
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 000036 (KY)
- Practice address
- 1885 Wright LN
Bonnieville, KY 42713-7437 - Phone
- (502) 592-4458
- NPI assigned
- May 30, 2008
- 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 |
|---|---|---|---|
| 000036 | KY | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 000036 | KY | Yes |
Addresses
Primary practice location
1885 Wright LN
Bonnieville, KY 42713-7437
Mailing address
1885 Wright LN
Bonnieville, KY 42713-7437
Phone (502) 592-4458
Other providers in Bonnieville, KY
- Alchemy Empowerment Counseling
- Cumberland Family Medical Center Inc
- Early Intervention for Little LLC
- Educere
- Lisa Fulkerson
- Heartland Medical Supplies
- Patty Lou Mabe
- Chiffon Rena Srygler
- Mysha Leigh Thompson
All providers in Bonnieville, 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 May 30, 2008. 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.