Provider Demographics
NPI:1629087903
Name:KISSEL, LOUIS STEVEN
Entity Type:Individual
Prefix:MR
First Name:LOUIS
Middle Name:STEVEN
Last Name:KISSEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2424 AINTREE WAY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40220-1048
Mailing Address - Country:US
Mailing Address - Phone:502-451-0436
Mailing Address - Fax:
Practice Address - Street 1:2424 AINTREE WAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-1048
Practice Address - Country:US
Practice Address - Phone:502-451-0436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPT-002635225100000X
IN05005532A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist