MEDICARE: LOUISVILLE PHYSICAL THERAPY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT-6084	OH

General Provider Information

NPI Number	:	1023201274
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOUISVILLE PHYSICAL THERAPY, LLC

Provider Business Mailing Address
First Line	:	PO BOX 87
Second Line	:
City	:	LOUISVILLE
State	:	OH
Zip	:	44641-0087
Country	:	US
Telephone Number	:	330-875-1300
Fax Number	:	330-875-1311

Provider Business Practice Location Address
First Line	:	513 E MAIN ST
Second Line	:
City	:	LOUISVILLE
State	:	OH
Zip	:	44641-1421
Country	:	US
Telephone Number	:	330-875-1300
Fax Number	:	330-875-1311

Authorized Official
Title or Position	:	OWNER/ PHYSICAL THERAPIST
Name	:	HANK JOSEPH LEWIS
Credential	:	PT
Telephone Number	:	330-875-1300

Provider Enumeration Date	:	08/21/2007
Last Update Date	:	02/10/2021

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