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General NPI Number Information
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NPI Number | 1053797829
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Entity Type | Organization
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Legal Business Name | PROREHAB OF LOUISVILLE, LLC
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Dates
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Enumeration Date | 08/04/2015
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Last Update Date | 08/04/2015
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Provider Practice Location Address
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Address Line | 5919 TIMBER RIDGE DR
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City | PROSPECT
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State | KY
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Zip | 40059-8132
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Country | US
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Telephone | 502-292-0800
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Fax | 502-292-0400
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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 | CEO/OWNER
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Name | LAURENCE BENZ
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Credential | DPT
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Telephone | 502-855-5903
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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 |
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License Number State | KY
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