Healthcare Provider Details

I. General information

NPI: 1013842566
Provider Name (Legal Business Name): KARL GREGORY CORTEZ PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

457 S STATE ROAD 145
FRENCH LICK IN
47432-1036
US

IV. Provider business mailing address

8150 W BEECHWOOD AVE APT 205
FRENCH LICK IN
47432-9028
US

V. Phone/Fax

Practice location:
  • Phone: 812-936-9756
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number05014628A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: