Provider Demographics
NPI:1487991915
Name:MUSGRAVE, JEFFERSON FRANKLIN (DPT)
Entity type:Individual
Prefix:
First Name:JEFFERSON
Middle Name:FRANKLIN
Last Name:MUSGRAVE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 BOB O LINK DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-3756
Mailing Address - Country:US
Mailing Address - Phone:859-258-8519
Mailing Address - Fax:859-258-8592
Practice Address - Street 1:700 BOB O LINK DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3756
Practice Address - Country:US
Practice Address - Phone:859-258-8519
Practice Address - Fax:859-258-8592
Is Sole Proprietor?:No
Enumeration Date:2013-01-03
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY005901225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist