MEDICARE: JUDITH ANN ROYER P.T.

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	PT001284	KY

General Provider Information

NPI Number	:	1881841757
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDITH ANN ROYER P.T.

Provider Business Mailing Address
First Line	:	521 ELINE AVE
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40207-3655
Country	:	US
Telephone Number	:	502-384-0226
Fax Number	:

Provider Business Practice Location Address
First Line	:	521 ELINE AVE
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40207-3655
Country	:	US
Telephone Number	:	502-384-0226
Fax Number	:

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

Provider Enumeration Date	:	08/22/2008
Last Update Date	:	08/22/2008

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