Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 006120 | KY |
NPI | 1003160722 |
---|---|
Provider Name | Joshua Chad Ford |
First Address | Franklin, TN 37067-7269 |
Second Address | Georgetown, KY 40324-7401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2012 |
Last Update Date | 02/11/2018 |