Healthcare Provider Details

I. General information

NPI: 1093397440
Provider Name (Legal Business Name): GABRIELLE FAHRENHOLZ DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GABRIELL RINGENBERG DPT

II. Dates (important events)

Enumeration Date: 04/26/2021
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6413 DUTCHMANS PKWY
LOUISVILLE KY
40205-3339
US

IV. Provider business mailing address

2122 YORK RD STE 300
OAK BROOK IL
60523-1925
US

V. Phone/Fax

Practice location:
  • Phone: 502-694-3500
  • Fax:
Mailing address:
  • Phone: 803-812-3656
  • Fax: 410-648-4878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number008200
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: