Organization
PROREHAB OF LOUISVILLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURENCE BENZ DPT (CEO/OWNER)
(502) 253-9202
Entity
Organization
Contact information
Practice address
4201 SPRINGHURST BLVD, SUITE 101, LOUISVILLE, KY 40241-6155
(502) 890-6565
(502) 890-6568
Mailing address
PO BOX 5629, EVANSVILLE, IN 47716-5629
(812) 401-3259
(812) 401-3259
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100412360
—
KY
01
—
K193730
MEDICARE
KY
Enumeration date
06/09/2016
Last updated
06/06/2017
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