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General NPI Number Information
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NPI Number | 1033507512
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Entity Type | Organization
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Legal Business Name | PROREHAB LOUISVILLE, LLC
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Dates
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Enumeration Date | 01/06/2015
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Last Update Date | 08/01/2022
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Provider Practice Location Address
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Address Line | 3052 BARDSTOWN RD
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City | LOUISVILLE
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State | KY
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Zip | 40205-3020
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Country | US
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Telephone | 502-454-5544
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Fax | 502-454-5562
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Provider Business Mailing Address
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Address Line | PO BOX 5629
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City | EVANSVILLE
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State | IN
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Zip | 47716-5629
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Country | US
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Telephone | 812-476-0409
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Fax | 812-476-1016
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Authorized Official
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Title or Position | OWNER
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Name | LAURENCE BENZ
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Credential | DPT
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Telephone | 812-759-7451
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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