MEDICARE: KLD THERAPY PLLC

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
2	261QP2000X	Physical Therapy Clinic/Center
3	225100000X	Physical Therapist	3352	KY

General Provider Information

NPI Number	:	1689903320
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KLD THERAPY PLLC

Provider Business Mailing Address
First Line	:	PO BOX 911063
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40591-1063
Country	:	US
Telephone Number	:	859-797-5513
Fax Number	:	859-898-0538

Provider Business Practice Location Address
First Line	:	880 CORPORATE DR STE 202
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40503-5449
Country	:	US
Telephone Number	:	859-797-5513
Fax Number	:	859-898-0538

Authorized Official
Title or Position	:	OWNER
Name	:	MR. KEITH ANDREW DUERLER
Credential	:	P.T.
Telephone Number	:	859-797-5513

Provider Enumeration Date	:	12/08/2009
Last Update Date	:	07/11/2023

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Directions to “KLD THERAPY PLLC ” Practice Location

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