Provider Demographics
NPI:1376208587
Name:BEST LIFE PHYSICAL THERAPY
Entity Type:Organization
Organization Name:BEST LIFE PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:LESLIE
Authorized Official - Last Name:RAIBLE-WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:502-354-6188
Mailing Address - Street 1:105 LYNDON LANE SUITE 106 B
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222
Mailing Address - Country:US
Mailing Address - Phone:502-354-6188
Mailing Address - Fax:
Practice Address - Street 1:105 LYNDON LANE SUITE 106 B
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222
Practice Address - Country:US
Practice Address - Phone:502-354-6188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-02
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty