Individual
JENNA LARUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
1227 GOSS AVE, LOUISVILLE, KY 40217-1239
(502) 636-1200
Mailing address
6156 SOUTHAMPTON DR, DAYTON, OH 45459-1913
(937) 776-3412
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-009048
KY
225100000X
Physical Therapist
PT020577
OH
Other
Enumeration date
06/01/2023
Last updated
12/06/2024
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