Provider Demographics
NPI:1972727055
Name:LOUISVILLE SPORTS AND INJURY CENTER INC
Entity Type:Organization
Organization Name:LOUISVILLE SPORTS AND INJURY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEINFELD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-881-3003
Mailing Address - Street 1:PO BOX 10653
Mailing Address - Street 2:
Mailing Address - City:RIVIERA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33419-0653
Mailing Address - Country:US
Mailing Address - Phone:561-881-3003
Mailing Address - Fax:561-881-3011
Practice Address - Street 1:4227 POPLAR LEVEL RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40213-1527
Practice Address - Country:US
Practice Address - Phone:502-451-5959
Practice Address - Fax:502-451-5041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4973111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty