Individual
THERESE M NIETUPSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1410 LONG RUN RD, LOUISVILLE, KY 40245-4334
(502) 244-8011
(502) 244-6631
Mailing address
1410 LONG RUN RD, LOUISVILLE, KY 40245-4334
(502) 244-8011
(502) 244-6631
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
004890
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000934732
ANTHEM
KY
Enumeration date
05/16/2015
Last updated
07/01/2015
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