# CHAMPION PHYSICAL THERAPY KENTUCKY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CORA Physical Therapy - Pineville
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588140586
- **Authorized official:** MR. STEPHEN R KRZYMINSKI (EXECUTIVE VICE PRESIDENT)
- **Authorized official phone:** (419) 221-6717

## Contact information

- **Practice address:** 103 S PINE ST, PINEVILLE, KY 40977-1610
- **Practice address phone:** (606) 254-2075
- **Practice address fax:** (606) 291-4251
- **Mailing address:** PO BOX 150, LIMA, OH 45802-0150
- **Mailing address phone:** (419) 221-6717
- **Mailing address fax:** (419) 222-0507

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0400X | Rehabilitation Clinic/Center | — | KY | Yes |

## Other

- **Enumeration date:** 07/13/2018
- **Last updated:** 10/17/2023