Organization
TOTAL BODY REHAB PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT J POWRIE PT (OWNER PRESIDENT)
(502) 412-5552
Entity
Organization
Contact information
Practice address
11330 MAPLE BROOK DR, LOUISVILLE, KY 40241
(502) 412-5552
(502) 412-2234
Mailing address
11330 MAPLE BROOK DR, LOUISVILLE, KY 40241
(502) 412-5552
(502) 412-2234
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
002453
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000336532
ANTHEM
KY
01
—
11221868
CAQH
—
01
—
2686482000
PASSPORT ADVANTAGE
KY
05
—
7100009380
—
KY
01
—
DE4890
RR MEDICARE
KY
Enumeration date
04/17/2007
Last updated
12/17/2009
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