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Individual

KEITH ANDREW DUERLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
880 CORPORATE DR STE 202, LEXINGTON, KY 40503-5449
(859) 797-5513
(859) 258-8592
Mailing address
PO BOX 911063, LEXINGTON, KY 40591-1063
(859) 797-5513
(859) 898-0538

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
003352
KY
225100000X
Physical Therapist
Primary
PT-003352
KY
2251S0007X
Sports Physical Therapist
PT-003352
KY
2251X0800X
Orthopedic Physical Therapist
PT-003352
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
36000818
ASC MEDICAID GROUP
KY
01
37903705
MEDICAID LAB GROUP
KY
01
4000501
MEDICARE LAB GROUP
KY
01
ASC1019
ASC MEDICARE GROUP
KY
01
CB5773
RR GROUP
KY
01
P00224418
RR MEDICARE PIN
KY
Enumeration date
11/14/2006
Last updated
07/11/2023
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