| Miss Heather Lacey Clark, DPT | |
|
703 E Main St Unit 1, Lebanon, KY 40033-8696 | |
| (270) 699-9503 | |
| (270) 699-3804 |
| Full Name | Miss Heather Lacey Clark |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 703 E Main St Unit 1, Lebanon, Kentucky |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538538350 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 006757 (Kentucky) | Primary |
| Provider Name | Kentucky Orthopedic Rehabilitation Llc |
|---|---|
| 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 |
|---|---|
| Miss Heather Lacey Clark, DPT 703 E Main St Unit 1, Lebanon, KY 40033-8696 Ph: (270) 699-9503 | Miss Heather Lacey Clark, DPT 703 E Main St Unit 1, Lebanon, KY 40033-8696 Ph: (270) 699-9503 |
Mrs. Laura Bandy Abell, PT, DPT, OCS Physical Therapist Medicare: Medicare Enrolled Practice Location: 703 E Main St Unit 1, Lebanon, KY 40033 Phone: 270-699-9503 | |
Justin Reed Hazel, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 703 E Main St Unit 1, Lebanon, KY 40033 Phone: 270-699-9503 Fax: 270-699-3804 | |
Mrs. Deanna Delaney, PT,DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 703 E Main St, Lebanon, KY 40033 Phone: 270-699-9503 | |
Lisa Michelle Ferris, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 703 E Main St, Suite 1, Lebanon, KY 40033 Phone: 270-699-9503 | |
Christopher Smith, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 703 E Main St Unit 1, Lebanon, KY 40033 Phone: 270-699-9503 Fax: 270-699-3804 | |
Madison Marie Osbourne, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 703 E Main St Unit 1, Lebanon, KY 40033 Phone: 270-699-9503 Fax: 270-699-3804 |