Brad Lee Profitt, PT, DPT, CSCS, DC, | |
1451 Diederich Blvd, Russell, KY 41169-1718 | |
(606) 388-2173 | |
Not Available |
Full Name | Brad Lee Profitt |
---|---|
Gender | Male |
Speciality | Physical Therapist |
Location | 1451 Diederich Blvd, Russell, Kentucky |
Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1518055714 | NPI | - | NPPES |
7562230 | Other | AETNA | |
000000216813 | Other | KY | ANTHEM 12 DIGIT PIN |
4402131 | Other | UNITED HEALTHCARE | |
350054419 | Other | KY | RR MEDICARE NUMBER |
85001504 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 250594 (Kentucky) | Secondary |
225100000X | Physical Therapist | 005907 (Kentucky) | Primary |
Mailing Address | Practice Location Address |
---|---|
Brad Lee Profitt, PT, DPT, CSCS, DC, 1451 Diederich Blvd, Russell, KY 41169-1718 Ph: (606) 836-6683 | Brad Lee Profitt, PT, DPT, CSCS, DC, 1451 Diederich Blvd, Russell, KY 41169-1718 Ph: (606) 388-2173 |
Jeremy Stephenson, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1451 Diederich Blvd, Russell, KY 41169 Phone: 606-836-6683 | |
Anita Frazier-brooks, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 452 Bluebird Dr, Russell, KY 41169 Phone: 606-922-2596 |