Provider Demographics
NPI:1851466015
Name:HEALING HANDS PHYSICAL THERAPY
Entity Type:Organization
Organization Name:HEALING HANDS PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:W
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:502-499-5559
Mailing Address - Street 1:11901 SHELBYVILLE RD
Mailing Address - Street 2:STE 125
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40243
Mailing Address - Country:US
Mailing Address - Phone:502-499-5559
Mailing Address - Fax:502-499-5399
Practice Address - Street 1:11901 SHELBYVILLE RD
Practice Address - Street 2:STE 125
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40243
Practice Address - Country:US
Practice Address - Phone:502-499-5559
Practice Address - Fax:502-499-5399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY003879225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY87000303Medicaid
KY000000190124OtherANTHEM
P14060Medicare UPIN
5026401Medicare ID - Type Unspecified