Healthcare Provider Details

I. General information

NPI: 1699604439
Provider Name (Legal Business Name): LIZETTE GERDING PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 FOUNTAIN CT STE 140
LEXINGTON KY
40509-1896
US

IV. Provider business mailing address

12300 PLANTSIDE DR
LOUISVILLE KY
40299-6345
US

V. Phone/Fax

Practice location:
  • Phone: 502-909-0772
  • Fax: 855-859-0123
Mailing address:
  • Phone: 502-909-0772
  • Fax: 855-859-0123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: