MEDICARE: CHRISTOPHER D RUNKLE 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
1	225100000X	Physical Therapist	007407	KY

General Provider Information

NPI Number	:	1245561356
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER D RUNKLE PT

Provider Business Mailing Address
First Line	:	5200 COMMERCE CROSSINGS DR FL 3
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40229-2182
Country	:	US
Telephone Number	:	502-861-5278
Fax Number	:

Provider Business Practice Location Address
First Line	:	1099 DUVAL ST STE 120
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40515-6489
Country	:	US
Telephone Number	:	859-639-0090
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2010
Last Update Date	:	08/19/2022

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Directions to “ CHRISTOPHER D RUNKLE PT” Practice Location

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