Organization
AT HOME PHYSICAL THERAPY
Active
Organization
AT HOME PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMARA D HUSTED P.T. (OWNER)
(502) 420-0901
Entity
Organization
Contact information
Practice address
512 VINELEAF DR, LOUISVILLE, KY 40222-4691
(502) 420-0901
(502) 420-0901
Mailing address
512 VINELEAF DR, LOUISVILLE, KY 40222-4691
(502) 420-0901
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
000923
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000295673
ANTHEM GROUP PIN NUMBER
KY
Enumeration date
10/03/2006
Last updated
09/20/2007
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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