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General NPI Number Information
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NPI Number | 1114099330
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Entity Type | Individual
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Provider Name | KEITH ANDREW DUERLER P.T.
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Gender | Male
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 07/11/2023
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Provider Practice Location Address
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Address Line | 880 CORPORATE DR STE 202
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City | LEXINGTON
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State | KY
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Zip | 40503-5449
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Country | US
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Telephone | 859-797-5513
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Fax | 859-258-8592
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Provider Business Mailing Address
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Address Line | PO BOX 911063
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City | LEXINGTON
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State | KY
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Zip | 40591-1063
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Country | US
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Telephone | 859-797-5513
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Fax | 859-898-0538
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 003352
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | PT-003352
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT-003352
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT-003352
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License Number State | KY
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