Organization
KENTUCKY ORTHOPEDIC REHABILITATION LLC
Active
Other names
Preston Physical Therpy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL E. TARVIN (VICE PRESIDENT)
(717) 972-1100
Entity
Organization
Contact information
Practice address
7926 PRESTON HWY, SUITE 101, LOUISVILLE, KY 40219-3848
(502) 964-5404
(502) 964-6164
Mailing address
4714 GETTYSBURG RD, LEGAL DEPARTMENT, MECHANICSBURG, PA 17055-4325
(717) 972-1100
(717) 975-9981
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
91040568
—
KY
Enumeration date
07/29/2005
Last updated
09/02/2010
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