MEDICARE: WARREN PHYSICAL THERAPY PLLC

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	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1376332775
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WARREN PHYSICAL THERAPY PLLC

Provider Business Mailing Address
First Line	:	880 CORPORATE DR STE 202
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40503-5449
Country	:	US
Telephone Number	:	859-219-2233
Fax Number	:	859-219-3322

Provider Business Practice Location Address
First Line	:	880 CORPORATE DR STE 202
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40503-5449
Country	:	US
Telephone Number	:	859-219-2233
Fax Number	:	859-219-3322

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	LEANNE FIELD
Credential	:
Telephone Number	:	859-219-2233

Provider Enumeration Date	:	05/02/2025
Last Update Date	:	02/03/2026

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