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General NPI Number Information
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NPI Number | 1700472735
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Entity Type | Individual
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Provider Name | ALEX RUBY APONTE JR. PTA
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Gender | Male
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Dates
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Enumeration Date | 12/14/2020
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Last Update Date | 01/03/2024
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Provider Practice Location Address
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Address Line | 7402 STEEPLECREST CIR APT 201
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City | LOUISVILLE
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State | KY
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Zip | 40222-9141
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Country | US
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Telephone | 502-650-0977
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Fax |
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Provider Business Mailing Address
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Address Line | 710 JENNYMAC DR
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City | LOUISVILLE
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State | KY
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Zip | 40229-6042
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Country | US
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Telephone | 502-269-6623
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | A04072
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License Number State | KY
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