Provider Demographics
NPI:1700253226
Name:FAIRLEIGH, BARBARA LOVEJOY (PT)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:LOVEJOY
Last Name:FAIRLEIGH
Suffix:
Gender:F
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:PO BOX 43174
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40253-0174
Mailing Address - Country:US
Mailing Address - Phone:502-643-1457
Mailing Address - Fax:
Practice Address - Street 1:203 ENGLISH STATION WAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40245-3915
Practice Address - Country:US
Practice Address - Phone:502-643-1457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-01
Last Update Date:2017-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY004413225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist