Organization
INJURY REHAB CENTER LLC
Active
Other names
Advanced Injury Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
DAWN WIETFELDT DC (MEMBER)
(502) 233-3456
Entity
Organization
Contact information
Practice address
102 MANOR AVE STE 202, BARDSTOWN, KY 40004-2553
(502) 233-3456
Mailing address
102 MANOR AVE STE 202, BARDSTOWN, KY 40004-2553
(502) 233-3456
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
Other
Enumeration date
05/21/2019
Last updated
11/28/2022
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