Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | A01073 | KY |
NPI | 1699981514 |
---|---|
Provider Name | Mr. Gregory K Duncan |
First Address | Paducah, KY 42001-6770 |
Second Address | Lacenter, KY 42056-0269 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2007 |
Last Update Date | 08/07/2007 |