Healthcare Provider Details

I. General information

NPI: 1861130882
Provider Name (Legal Business Name): SYDNEY ANN ROBY PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2022
Last Update Date: 12/27/2024
Certification Date: 12/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

431 ADAM SHEPHERD PKWY STE 1
SHEPHERDSVILLE KY
40165-6640
US

IV. Provider business mailing address

503 OLD MILL STREAM LN
SHEPHERDSVILLE KY
40165-6347
US

V. Phone/Fax

Practice location:
  • Phone: 502-921-0272
  • Fax:
Mailing address:
  • Phone: 502-594-4208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number008596
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: