Provider Demographics
NPI:1659498657
Name:VELARDE, CHERYL O (DPT)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:O
Last Name:VELARDE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 ALCOTT RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-4021
Mailing Address - Country:US
Mailing Address - Phone:502-724-0468
Mailing Address - Fax:
Practice Address - Street 1:3584 SPRINGHURST BLVD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-4141
Practice Address - Country:US
Practice Address - Phone:502-339-4700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5086225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist