=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003052176
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SENIORS PHYSICAL THERAPY, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/19/2008
-----------------------------------------------------
Last Update Date | 01/12/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 601 LAKE FOREST PARKWAY
-----------------------------------------------------
City | LOUISVILLE
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40245-4685
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 502-263-9929
-----------------------------------------------------
Fax | 502-614-8732
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 601 LAKE FOREST PARKWAY
-----------------------------------------------------
City | LOUISVILLE
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40245-4685
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 502-263-9929
-----------------------------------------------------
Fax | 502-614-8732
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICAL THERAPIST/PRESIDENT
-----------------------------------------------------
Name | JEFFREY DAVID ARNSPERGER
-----------------------------------------------------
Credential | PHYSICAL THERAPIST
-----------------------------------------------------
Telephone | 502-263-9929
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 005323
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------