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General NPI Number Information
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NPI Number | 1770615916
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Entity Type | Organization
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Legal Business Name | PINNACLE PHYSICAL THERAPY INC
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 02/28/2013
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Provider Practice Location Address
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Address Line | 9204 TAYLORSVILLE RD SUITE 101
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City | LOUISVILLE
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State | KY
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Zip | 40299-1787
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Country | US
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Telephone | 502-499-5959
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Fax | 502-499-5454
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Provider Business Mailing Address
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Address Line | 9204 TAYLORSVILLE RD SUITE 101
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City | LOUISVILLE
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State | KY
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Zip | 40299-1787
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Country | US
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Telephone | 502-499-5959
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Fax | 502-499-5454
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | MR. DAVID LANE BROWN
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Credential | MSPT
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Telephone | 502-499-5959
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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 | 001785
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 003788
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License Number State | KY
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