Provider Demographics
NPI:1326083775
Name:CAUDILL, JANELLE M (PT, DPT)
Entity Type:Individual
Prefix:MISS
First Name:JANELLE
Middle Name:M
Last Name:CAUDILL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:JANELLE
Other - Middle Name:M
Other - Last Name:CIOLEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9880 ANGIES WAY STE 100
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-2851
Mailing Address - Country:US
Mailing Address - Phone:502-339-6490
Mailing Address - Fax:
Practice Address - Street 1:9880 ANGIES WAY STE 100
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-2851
Practice Address - Country:US
Practice Address - Phone:502-339-6490
Practice Address - Fax:502-339-6492
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY004755225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist