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General NPI Number Information
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NPI Number | 1780876474
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Entity Type | Individual
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Provider Name | EMILY CATHERINE BALD P.T.
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Gender | Female
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Dates
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Enumeration Date | 08/15/2007
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Last Update Date | 08/15/2007
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Provider Practice Location Address
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Address Line | 6317 HIGHWAY 329
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City | CRESTWOOD
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State | KY
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Zip | 40014-9040
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Country | US
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Telephone | 502-384-0910
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Fax |
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Provider Business Mailing Address
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Address Line | 1111 S 2ND ST APT A
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City | LOUISVILLE
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State | KY
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Zip | 40203-5431
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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 |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT-004644
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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 | 62 024740
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License Number State | NY
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