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NPI Code Detail

MEDICARE: INDUSTRIAL REHABWORKS PSC

MEDICARE: INDUSTRIAL REHABWORKS PSC
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 TherapistKY

General Provider Information

NPI Number : 1780702860
Entity Type Code : Organization
Provider Name (Legal Business Name) : INDUSTRIAL REHABWORKS PSC
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 : OFFICE MANAGER
Name : MRS. JUDITH ANNE MICHAEL
Credential :
Telephone Number : 859-266-0404
Provider Enumeration Date : 03/27/2007
Last Update Date : 10/11/2012

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