Provider Demographics
NPI:1073754834
Name:OSBORNE, AIMEE LYNN (LMT)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:LYNN
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13113 EASTPOINT PARK BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-4191
Mailing Address - Country:US
Mailing Address - Phone:502-244-5437
Mailing Address - Fax:502-244-5003
Practice Address - Street 1:13113 EASTPOINT PARK BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-4191
Practice Address - Country:US
Practice Address - Phone:502-244-5437
Practice Address - Fax:502-244-5003
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-09
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1245225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist