Healthcare Provider Details

I. General information

NPI: 1942281449
Provider Name (Legal Business Name): CATHERINE LEA GOHRBAND PT, DPT, PCS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 12/16/2020
Certification Date: 12/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

290 ALUMNI DR STE 104
LEXINGTON KY
40503
US

IV. Provider business mailing address

290 ALUMNI DR STE 104
LEXINGTON KY
40503-1601
US

V. Phone/Fax

Practice location:
  • Phone: 859-218-1684
  • Fax: 859-257-0284
Mailing address:
  • Phone: 859-218-1648
  • Fax: 859-257-0284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberPT3549
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT003549
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number06636
License Number StateKY
# 4
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number006636
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: