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NPI Code Detail

MEDICARE: PROREHAB OF LOUISVILLE LLC

MEDICARE: PROREHAB OF LOUISVILLE 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
1261QM1300XMulti-Specialty Clinic/Center
2261QP2000XPhysical Therapy Clinic/Center

General Provider Information

NPI Number : 1780101873
Entity Type Code : Organization
Provider Name (Legal Business Name) : PROREHAB OF LOUISVILLE LLC
Provider Business Mailing Address
First Line : PO BOX 5629
Second Line :
City : EVANSVILLE
State : IN
Zip : 47716-5629
Country : US
Telephone Number : 812-401-3258
Fax Number : 812-773-6365
Provider Business Practice Location Address
First Line : 8019 DIXIE HWY STE 106
Second Line :
City : LOUISVILLE
State : KY
Zip : 40258-1303
Country : US
Telephone Number : 502-200-6970
Fax Number : 502-200-6973
Authorized Official
Title or Position : CEO/OWNER
Name : LAURENCE BENZ
Credential : PT
Telephone Number : 502-442-7697
Provider Enumeration Date : 08/29/2017
Last Update Date : 08/29/2017

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Directions to “PROREHAB OF LOUISVILLE LLC ” Practice Location

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