Healthcare Provider Details

I. General information

NPI: 1043255326
Provider Name (Legal Business Name): KAREN ESTHER CRONIN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3834A TAYLORSVILLE RD SUITE 4
LOUISVILLE KY
40220-1362
US

IV. Provider business mailing address

PO BOX 911148
LEXINGTON KY
40591-1148
US

V. Phone/Fax

Practice location:
  • Phone: 502-451-9511
  • Fax: 502-451-7881
Mailing address:
  • Phone: 859-278-2121
  • Fax: 859-276-2795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number000532
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: