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General NPI Number Information
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NPI Number | 1366250052
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Entity Type | Organization
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Legal Business Name | FOUNDATIONS PHYSICAL THERAPY AND WELLNESS PLLC
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Dates
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Enumeration Date | 12/26/2024
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Last Update Date | 12/26/2024
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Provider Practice Location Address
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Address Line | 1920 STANLEY GAULT PKWY STE 103
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City | LOUISVILLE
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State | KY
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Zip | 40223-4209
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Country | US
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Telephone | 309-229-0257
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Fax |
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Provider Business Mailing Address
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Address Line | 8364 GRAND TREVI DR
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City | LOUISVILLE
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State | KY
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Zip | 40228-4215
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALLYSON HARPER
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Credential |
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Telephone | 309-229-0257
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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 |
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