Provider Demographics
NPI:1154448298
Name:PHYSICAL THERAPY SPECIALISTS OF LOUISVILLE, INC.
Entity Type:Organization
Organization Name:PHYSICAL THERAPY SPECIALISTS OF LOUISVILLE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, PT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:I
Authorized Official - Last Name:ORENDORF
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:502-895-5875
Mailing Address - Street 1:718 WATERFORD RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-1757
Mailing Address - Country:US
Mailing Address - Phone:502-895-5875
Mailing Address - Fax:502-895-1812
Practice Address - Street 1:718 WATERFORD RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-1757
Practice Address - Country:US
Practice Address - Phone:502-895-5875
Practice Address - Fax:502-895-1812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY000686225100000X
KY000795225100000X
KYKY-R0018225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty