1033261235 NPI number — HAMPTON PHYSICAL THERAPY,PSC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033261235 NPI number — HAMPTON PHYSICAL THERAPY,PSC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HAMPTON PHYSICAL THERAPY,PSC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033261235
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/22/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5050 B VILLAGE SQUARE DR.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PADUCAH
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
270-443-0681
Provider Business Mailing Address Fax Number:
270-442-7948

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5050 B VILLAGE SQUARE DR.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PADUCAH
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-443-0681
Provider Business Practice Location Address Fax Number:
270-442-7948
Provider Enumeration Date:
01/17/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HAMPTON
Authorized Official First Name:
CHERI
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER, CEI
Authorized Official Telephone Number:
270-443-0681

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)