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General NPI Number Information
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NPI Number | 1659673796
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Entity Type | Organization
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Legal Business Name | TOTAL CARE REHAB PLLC
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Dates
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Enumeration Date | 11/22/2010
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Last Update Date | 11/22/2010
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Provider Practice Location Address
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Address Line | 2813 N HURSTBOURNE PKWY
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City | LOUISVILLE
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State | KY
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Zip | 40223-1251
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Country | US
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Telephone | 502-552-6100
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 100
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City | GOSHEN
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State | KY
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Zip | 40026-0100
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Country | US
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Telephone | 502-552-6100
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Fax |
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Authorized Official
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Title or Position | OWNER/PT
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Name | ANJALI AJMANI
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Credential | PT
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Telephone | 502-552-6100
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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 | 004785
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License Number State | KY
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