MEDICARE: MRS. KATHY RENEE RORER PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	001237	KY

General Provider Information

NPI Number	:	1639115314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATHY RENEE RORER PT, DPT

Provider Business Mailing Address
First Line	:	2345 NEW HOLT RD
Second Line	:
City	:	PADUCAH
State	:	KY
Zip	:	42001-7404
Country	:	US
Telephone Number	:	270-554-2883
Fax Number	:	270-554-2885

Provider Business Practice Location Address
First Line	:	2345 NEW HOLT RD
Second Line	:
City	:	PADUCAH
State	:	KY
Zip	:	42001-7404
Country	:	US
Telephone Number	:	270-554-2883
Fax Number	:	270-554-2885

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2006
Last Update Date	:	12/01/2020

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