Elliot Richard Mattingly, PT, DPT | |
875 Pennsylvania Ave, Bardstown, KY 40004-2529 | |
(502) 349-6961 | |
Not Available |
Full Name | Elliot Richard Mattingly |
---|---|
Gender | Male |
Speciality | Physical Therapy |
Experience | 13 Years |
Location | 875 Pennsylvania Ave, Bardstown, Kentucky |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1154695864 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2251X0800X | Physical Therapist - Orthopedic | 005992 (Kentucky) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Kentucky Orthopedic Rehabilitation Llc | 0345157293 | 731 |
Provider Name | Kentucky Orthopedic Rehabilitation Llc |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1093715054 PECOS PAC ID: 0345157293 Enrollment ID: O20090211000813 |
Provider Name | Sn Kentuckiana Rehab Llc |
---|---|
Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1609349018 PECOS PAC ID: 1254671464 Enrollment ID: O20190326002841 |
Mailing Address | Practice Location Address |
---|---|
Elliot Richard Mattingly, PT, DPT 439 Bloomfield Rd, Bardstown, KY 40004-2010 Ph: (502) 460-0125 | Elliot Richard Mattingly, PT, DPT 875 Pennsylvania Ave, Bardstown, KY 40004-2529 Ph: (502) 349-6961 |
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