Provider Demographics
NPI:1518290006
Name:HUELLEMEIER, ROBERT G (DPT)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:G
Last Name:HUELLEMEIER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 WINDSOR PATH
Mailing Address - Street 2:SUITE 5
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-9617
Mailing Address - Country:US
Mailing Address - Phone:502-370-4240
Mailing Address - Fax:502-370-4242
Practice Address - Street 1:105 WINDSOR PATH
Practice Address - Street 2:SUITE 5
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-9617
Practice Address - Country:US
Practice Address - Phone:502-370-4240
Practice Address - Fax:502-370-4242
Is Sole Proprietor?:No
Enumeration Date:2009-09-15
Last Update Date:2013-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY005490225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYK020181Medicare Oscar/Certification
KYK020180Medicare Oscar/Certification