Basic Information
| Provider Information | |||||||||
| NPI: | 1497824718 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WHALEY | ||||||||
| FirstName: | TANSY | ||||||||
| MiddleName: | RIDGEWAY | ||||||||
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| Credential: | P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 600 PERIMETER DR | ||||||||
| Address2: | SUITE 175 | ||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405174119 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592681201 | ||||||||
| FaxNumber: | 8592681202 | ||||||||
| Practice Location | |||||||||
| Address1: | 600 PERIMETER DR | ||||||||
| Address2: | SUITE 175 | ||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405174119 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592681201 | ||||||||
| FaxNumber: | 8592681202 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/08/2006 | ||||||||
| LastUpdateDate: | 05/20/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 003866 | KY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.