Provider Demographics
NPI:1366442105
Name:PHYSICAL MEDICINE SERVICES, INC.
Entity type:Organization
Organization Name:PHYSICAL MEDICINE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:WINKLER
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:270-753-6477
Mailing Address - Street 1:732 VINE ST
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-2630
Mailing Address - Country:US
Mailing Address - Phone:270-753-6477
Mailing Address - Fax:270-753-6478
Practice Address - Street 1:732 VINE ST
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-2630
Practice Address - Country:US
Practice Address - Phone:270-753-6477
Practice Address - Fax:270-753-6478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-22
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY001536174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000059678OtherANTHEM BCBS/GROUP
KY8700036000Medicaid
KYC10478OtherRAILROAD MEDICARE
KY000000049118OtherANTHEM BCBS
KY5012701Medicare ID - Type UnspecifiedPHYSICAL THERAPISTS