Provider Demographics
NPI:1346531498
Name:ELDER, KATHERINE (PT)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:ELDER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9400 WILLIAMSBURG PLZ
Mailing Address - Street 2:SUITE
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-5097
Mailing Address - Country:US
Mailing Address - Phone:502-412-4486
Mailing Address - Fax:502-412-4490
Practice Address - Street 1:9400 WILLIAMSBURG PLZ
Practice Address - Street 2:SUITE
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-5093
Practice Address - Country:US
Practice Address - Phone:502-412-4486
Practice Address - Fax:502-412-4490
Is Sole Proprietor?:No
Enumeration Date:2011-04-25
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYK002140Medicare PIN