NPI 1174006209

Shaun Vickery, PTMPT

Practitioner Physical Therapist Madisonville, KY

Practice location

Address: 425 Island Ford Road, Madisonville, KY 42431
Phone: (270) 825-0166
Mailing address: 106 Genevieve Dr, Madisonville, KY 42431-5806

Registered specialties

Physical Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225100000X Licence 004425 (KY)

Other Physical Therapist providers in Kentucky →

Registry record

NPI: 1174006209
Entity type: Individual
Sex (as registered): Male
NPI issued: 14 Sep 2018
Record last updated: 14 Sep 2018

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.