Provider Demographics
NPI:1700852126
Name:LAPOLE, WILLIAM CHRISTOPHER (KCSA, OTC, ATC)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:CHRISTOPHER
Last Name:LAPOLE
Suffix:
Gender:M
Credentials:KCSA, OTC, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6516 CALM RIVER WAY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-4285
Mailing Address - Country:US
Mailing Address - Phone:740-550-1269
Mailing Address - Fax:
Practice Address - Street 1:6400 DUTCHMANS PKWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-3340
Practice Address - Country:US
Practice Address - Phone:502-721-8288
Practice Address - Fax:502-721-7606
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-25
Last Update Date:2009-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYAT6032255A2300X
OHAT-0021272255A2300X
KYSA188246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant