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General NPI Number Information
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NPI Number | 1033651955
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Entity Type | Organization
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Legal Business Name | THERABILITIES LLC
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Dates
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Enumeration Date | 11/09/2016
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Last Update Date | 11/09/2016
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Provider Practice Location Address
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Address Line | 7926 PRESTON HWY SUITE 103
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City | LOUISVILLE
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State | KY
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Zip | 40219-3848
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Country | US
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Telephone | 502-272-4700
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Fax | 502-242-1958
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Provider Business Mailing Address
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Address Line | 13408 SHADY CREEK CIRCLE
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City | LOUISVILLE
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State | KY
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Zip | 40299-4578
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Country | US
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Telephone | 502-418-2318
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Fax | 502-242-1958
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Authorized Official
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Title or Position | MANAGER
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Name | RONALD W COLE
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Credential | PT, PH.D.
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Telephone | 502-418-2318
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 003879
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License Number State | KY
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