MEDICARE: MRS. LORI ROBY JARBOE 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	003347	KY

General Provider Information

NPI Number	:	1497977862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LORI ROBY JARBOE PT

Provider Business Mailing Address
First Line	:	430 ROLLING HEIGHTS BLVD
Second Line	:
City	:	RINEYVILLE
State	:	KY
Zip	:	40162-9409
Country	:	US
Telephone Number	:	270-234-0429
Fax Number	:	270-234-0429

Provider Business Practice Location Address
First Line	:	430 ROLLING HEIGHTS BLVD
Second Line	:
City	:	RINEYVILLE
State	:	KY
Zip	:	40162-9409
Country	:	US
Telephone Number	:	270-234-0429
Fax Number	:	270-234-0429

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

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	07/08/2007

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