Provider Demographics
NPI:1952463366
Name:FARLEY, RICK (LPT)
Entity Type:Individual
Prefix:
First Name:RICK
Middle Name:
Last Name:FARLEY
Suffix:
Gender:M
Credentials:LPT
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 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:
Practice Address - Street 1:9300 STONESTREET RD
Practice Address - Street 2:SUITE 400
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40272-2863
Practice Address - Country:US
Practice Address - Phone:502-935-9776
Practice Address - Fax:502-935-9813
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0030982251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYK065880OtherMEDICARE- NORTON LEATHERMAN SPINE
KY000000771694OtherANTHEM- NORTON LEATHERMAN SPINE
KY7100233590Medicaid
KY000000327265OtherANTHEM BLUE SHIELD
KYP00315857OtherRAILROAD MEDICARE
KYP00315857OtherRAILROAD MEDICARE