Most Relevant Information
Provider Data
| NPI Number: | 1003014846 |
| Provider Name: | SHARON FORD FISH PTA |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: | A00910 |
Most Important Dates
| Enumeration Date: | 07/03/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
1101 WOODLAND DR
ELIZABETHTOWN
KY
427012749
Practice Location Phone/Fax
| Phone: | 2707656106 |
| Fax: | 2707376690 |
Provider Mailing Location
599 MAYER LN
ELIZABETHTOWN
KY
427017433
Provider Mailing Phone/Fax
| Phone: | 2707693555 |
| Fax: |