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General NPI Number Information
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NPI Number | 1760608871
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Entity Type | Organization
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Legal Business Name | WOMEN'S THERAPEUTIC SERVICES, INC.
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | SUBURBAN MEDICAL PLAZA III 4121 DUTCHMAN'S LN -STE 515
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City | LOUISVILLE
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State | KY
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Zip | 40207
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Country | US
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Telephone | 502-895-2440
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Fax | 502-897-2311
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Provider Business Mailing Address
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Address Line | SUBURBAN MEDICAL PLAZA III 4121 DUTCHMAN'S LN -STE 515
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City | LOUISVILLE
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State | KY
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Zip | 40207
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Country | US
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Telephone | 502-895-2440
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Fax | 502-897-2311
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DEBORAH A BRODZIK
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Credential | PT
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Telephone | 502-895-2440
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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 | 002736
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License Number State | KY
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