NPI 1831570399

Loki INC

Organisation Preferred Provider Organization Betsy Layne, KY

Practice location

Address: 10824 US 23 South Suite 102, Betsy Layne, KY 41605
Phone: (606) 478-1111
Fax: (606) 478-1113
Mailing address: P.O. Box 68, Betsy Layne, KY 41605

Authorised official

Name: Franklin Stumbo
Title: Owner/Physical Therapist
Phone: (606) 478-1111

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 003789 (KY)

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Registry record

NPI: 1831570399
Entity type: Organization
NPI issued: 10 Jun 2015
Record last updated: 10 Jun 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.