Provider Demographics
NPI:1821248733
Name:KERSEY, ROBERT (PTA)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:KERSEY
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 LAZY RIVER NORTH PKWY
Mailing Address - Street 2:
Mailing Address - City:SHEPHERDSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40165-6225
Mailing Address - Country:US
Mailing Address - Phone:502-543-1790
Mailing Address - Fax:
Practice Address - Street 1:140 LAZY RIVER NORTH PKWY
Practice Address - Street 2:
Practice Address - City:SHEPHERDSVILLE
Practice Address - State:KY
Practice Address - Zip Code:40165-6225
Practice Address - Country:US
Practice Address - Phone:502-543-1790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-27
Last Update Date:2008-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYA01308208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation