Provider Demographics
NPI:1083851786
Name:JOICE, CRYSTAL LEE (DPT)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:LEE
Last Name:JOICE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12935 SHELBYVILLE RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40243-1592
Mailing Address - Country:US
Mailing Address - Phone:502-489-5002
Mailing Address - Fax:502-489-8002
Practice Address - Street 1:12935 SHELBYVILLE RD
Practice Address - Street 2:SUITE 106
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40243-1592
Practice Address - Country:US
Practice Address - Phone:502-489-5002
Practice Address - Fax:502-489-8002
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-16
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY005367225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist