Healthcare Provider Details

I. General information

NPI: 1053519892
Provider Name (Legal Business Name): MICHAEL LEE APPELL PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5111 COMMERCE CROSSINGS DR STE 100
LOUISVILLE KY
40229-2192
US

IV. Provider business mailing address

3705 MAMARONECK RD
LOUISVILLE KY
40218-1617
US

V. Phone/Fax

Practice location:
  • Phone: 502-968-9110
  • Fax: 502-968-9124
Mailing address:
  • Phone: 502-485-1927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number002514
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: