Organization
DIPLOMAT PHYSICAL THERAPY CLINIC LLC
Active
Other names
diplomat physical therapy clinic llc
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDREW MORRICE NANKWENYA NURSE (OWNER)
(502) 712-1749
Entity
Organization
Contact information
Practice address
4400 BRECKENRIDGE LN STE 300B, LOUISVILLE, KY 40218-4129
(502) 749-6411
(502) 749-6413
Mailing address
4400 BRECKENRIDGE LN STE 300B, LOUISVILLE, KY 40218-4129
(502) 749-6411
(502) 749-6413
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
08/30/2021
Last updated
08/30/2021
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