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NPI Code Detail

MEDICARE: JOAN H GERTZ PT

MEDICARE: JOAN H GERTZ PT
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
1225100000XPhysical Therapist000658KY

General Provider Information

NPI Number : 1134402522
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOAN H GERTZ PT
Provider Business Mailing Address
First Line : 261 RUCCIO WAY STE 190
Second Line :
City : LEXINGTON
State : KY
Zip : 40503-3566
Country : US
Telephone Number : 859-266-0404
Fax Number : 859-266-0621
Provider Business Practice Location Address
First Line : 261 RUCCIO WAY STE 190
Second Line :
City : LEXINGTON
State : KY
Zip : 40503-3566
Country : US
Telephone Number : 859-266-0404
Fax Number : 859-266-0621
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2011
Last Update Date : 09/22/2011

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