Individual
MS. ERIN L RAIBLE-WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, OCS
Contact information
Practice address
4042 DUTCHMANS LN, LOUISVILLE, KY 40207-4712
(502) 899-9363
(502) 899-9365
Mailing address
4042 DUTCHMANS LN, LOUISVILLE, KY 40207-4712
(502) 899-9363
(502) 899-9365
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
003915
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000484215
ANTHEM PROVIDER ID
KY
01
—
6813
OCS CERTIFICATION
KY
01
—
KY003915
KY STATE LICENSE
—
Enumeration date
01/26/2007
Last updated
05/13/2010
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