Healthcare Provider Details

I. General information

NPI: 1679628267
Provider Name (Legal Business Name): CORNERSTONE PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 08/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 HIGHLAND PARK DR SUITE 1
RICHMOND KY
40475-3546
US

IV. Provider business mailing address

370 HIGHLAND PARK DR SUITE 1
RICHMOND KY
40475-3546
US

V. Phone/Fax

Practice location:
  • Phone: 859-623-4567
  • Fax: 859-623-7865
Mailing address:
  • Phone: 859-623-4567
  • Fax: 859-623-7865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. KEVIN TODD OCHS
Title or Position: DIRECTOR OWNER
Credential:
Phone: 859-623-4567