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General NPI Number Information
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NPI Number | 1124766795
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Entity Type | Individual
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Provider Name | ELIZABETH CLAIRE HART ATC, PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 05/24/2022
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Last Update Date | 10/06/2022
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Provider Practice Location Address
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Address Line | 4121 SHELBYVILLE RD
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City | LOUISVILLE
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State | KY
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Zip | 40207-3205
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Country | US
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Telephone | 502-893-1380
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Fax |
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Provider Business Mailing Address
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Address Line | 1201 EQUESTRIAN LAKES LN
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City | FINCHVILLE
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State | KY
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Zip | 40022-4704
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Country | US
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Telephone | 573-521-8251
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Fax |
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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 |
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License Number State | KY
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