Kanissa E Hildreth, DPT | |
102 W Maple St, Scottsville, KY 42164-1134 | |
(270) 745-0987 | |
(270) 745-0986 |
Full Name | Kanissa E Hildreth |
---|---|
Gender | Female |
Speciality | Physical Therapist |
Location | 102 W Maple St, Scottsville, Kentucky |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1821691395 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 008173 (Kentucky) | Primary |
Provider Name | Gilbert Barbee Moore & Mcilvoy Psc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1114948288 PECOS PAC ID: 4082511167 Enrollment ID: O20031217000136 |
Mailing Address | Practice Location Address |
---|---|
Kanissa E Hildreth, DPT Po Box 2697, Bowling Green, KY 42102-7697 Ph: (270) 745-1100 | Kanissa E Hildreth, DPT 102 W Maple St, Scottsville, KY 42164-1134 Ph: (270) 745-0987 |
Mrs. Keishia Danielle Embry, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 102 W Maple St, Scottsville, KY 42164 Phone: 270-239-6640 | |
Mr. Kelly Steven Holman, PT, MS Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 208 S Court St, Scottsville, KY 42164 Phone: 270-239-6640 Fax: 270-239-6674 | |
Carrie Joyce Reed, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 456 Burnley Rd, Scottsville, KY 42164 Phone: 270-622-2847 Fax: 270-622-2891 | |
Derek Lewis Brockman, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 102 W Maple St, Scottsville, KY 42164 Phone: 270-239-6640 |