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Organization

LOUISVILLE PEDIATRIC THERAPY SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHELLE MCNALLY WILDER (PRESIDENT)
(502) 777-2965
Entity
Organization

Contact information

Practice address
14007 HICKORY RIDGE RD, LOUISVILLE, KY 40245-5176
(502) 777-2965
Mailing address
PO BOX 43372, LOUISVILLE, KY 40253-0372
(502) 777-2965

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary

Other

Enumeration date
05/16/2008
Last updated
05/16/2008
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