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Organization
KENTUCKY ORTHOPEDIC REHAB TEAM
Active
Organization
KENTUCKY ORTHOPEDIC REHAB TEAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA MIX (CREDENTIALING COORDINATOR)
(270) 766-1990
Entity
Organization
Contact information
Practice address
4010 DUPONT CIR STE 574, LOUISVILLE, KY 40207-4843
(502) 899-9927
Mailing address
4010 DUPONT CIR STE 574, LOUISVILLE, KY 40207-4843
(502) 899-9927
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
KY
Other
Enumeration date
11/24/2006
Last updated
07/21/2022
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