Provider Demographics
NPI:1760607022
Name:ORENDORF, ROBERT I (PT)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:I
Last Name:ORENDORF
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:718 WATERFORD RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-1757
Mailing Address - Country:US
Mailing Address - Phone:502-895-5875
Mailing Address - Fax:502-895-1812
Practice Address - Street 1:4139 CADILLAC CT
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40213-1578
Practice Address - Country:US
Practice Address - Phone:502-238-5150
Practice Address - Fax:502-238-5180
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY000686225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist