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Individual

RODOLFO TOM DORANTES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
10301 CONEFLOWER LN, PROSPECT, KY 40059-8355
(502) 290-6706
Mailing address
427 HARRIS PL, LOUISVILLE, KY 40222-6701
(502) 649-3504

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA02228
KY

Other

Enumeration date
11/27/2023
Last updated
11/27/2023
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