Provider Demographics
NPI:1013495746
Name:VARDEMAN, JAMES CHRISTOPHER (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:CHRISTOPHER
Last Name:VARDEMAN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7603 CONNIE DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40258-2635
Mailing Address - Country:US
Mailing Address - Phone:502-718-3043
Mailing Address - Fax:
Practice Address - Street 1:5120 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40216-1775
Practice Address - Country:US
Practice Address - Phone:502-449-0449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-03
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY007483225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist