OrganizationBlue Grass Physiotherapy, PllcPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address117 Tradepark Dr, Somerset, KY 42503-3428(606) 678-5708PECOS EnrollmentBased on the most recent information from CMS, provider Blue Grass Physiotherapy, Pllc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1679669600Provider TypeOrganizationFull NameBlue Grass Physiotherapy, PllcSubpartNoEnumeration Date10/5/2006Last Updated8/22/2020Contact InformationPractice LocationPractice Address117 Tradepark Dr, Somerset, KY 42503-3428Phone(606) 678-5708Fax(606) 678-4336Mailing LocationMailing Address117 Tradepark Dr, Somerset, KY 42503-3428Phone(606) 678-5708Fax(606) 678-4336Authorized OfficialNameLoze, George William (Co-Owner)Phone(606) 678-5708Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID64-00220DescriptionOtherIssuerUHC PROVIDER NUMBERSKentucky