Healthcare Provider Details

I. General information

NPI: 1265553648
Provider Name (Legal Business Name): OLDHAM COUNTY PHYSICAL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 LA GRANGE RD
PEWEE VALLEY KY
40056-9168
US

IV. Provider business mailing address

309 LA GRANGE RD P. O. BOX 615
PEWEE VALLEY KY
40056-9168
US

V. Phone/Fax

Practice location:
  • Phone: 502-243-6868
  • Fax: 502-243-6867
Mailing address:
  • Phone: 502-243-6868
  • Fax: 502-243-6867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateKY

VIII. Authorized Official

Name: MRS. KAREN SNIDER
Title or Position: OWNER
Credential: P. T.
Phone: 502-243-6868