Organization
PERSONAL FITNESS AND REHABILITATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD JOHNSON (CEO)
(814) 574-6070
Entity
Organization
Contact information
Practice address
12101 SYCAMORE STATION PL, LOUISVILLE, KY 40299-5190
(814) 574-6070
Mailing address
12101 SYCAMORE STATION PL, LOUISVILLE, KY 40299-5190
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
225100000X
Physical Therapist
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
12/12/2017
Last updated
01/24/2018
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