# LOUISVILLE PHYSICAL MEDICINE PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508374315
- **Authorized official:** JANE E WEIR (QUALITY ASSURANCE DIRECTOR)
- **Authorized official phone:** (205) 694-2020

## Contact information

- **Practice address:** 3999 DUTCHMANS LN STE 4C, LOUISVILLE, KY 40207-4745
- **Practice address phone:** (502) 744-3239
- **Mailing address:** PO BOX 622, GARDENDALE, AL 35071-0622
- **Mailing address phone:** (205) 694-2020
- **Mailing address fax:** (205) 380-0354

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | 26921 | KY | Yes |

## Other

- **Enumeration date:** 01/15/2018
- **Last updated:** 06/16/2018