Healthcare Provider Details

I. General information

NPI: 1093043291
Provider Name (Legal Business Name): HAND & PHYSICAL REHAB, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2009
Last Update Date: 11/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2932 BRECKENRIDGE LN SUITE 10
LOUISVILLE KY
40220-1409
US

IV. Provider business mailing address

2932 BRECKENRIDGE LN SUITE 10
LOUISVILLE KY
40220-1409
US

V. Phone/Fax

Practice location:
  • Phone: 502-895-3972
  • Fax: 502-897-5299
Mailing address:
  • Phone: 502-895-3972
  • Fax: 502-897-5299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251H1200X
TaxonomyHand Physical Therapist
License Number000468
License Number StateKY

VIII. Authorized Official

Name: MRS. CONNIE E. LANE
Title or Position: OWNER
Credential: P.T., C.H.T.
Phone: 502-895-3972