Beau Alstatt, PTA

Individual provider Active NPI Physical Therapy Assistant · Louisville, KY

NPI 1477083004 · NPPES record last updated Jun 15, 2017

Key facts

NPI
1477083004
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
A00809 (KY)
Practice address
9127 Galene Dr
Louisville, KY 40299-1579
Phone
(502) 896-8147
NPI assigned
Jun 15, 2017
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
A00809KYMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A00809 KY Yes

Addresses

Primary practice location

9127 Galene Dr
Louisville, KY 40299-1579

Mailing address

330 Twelve Oaks Dr
Mount Washington, KY 40047-7232

Other providers in Louisville, KY

All providers in Louisville, KY · Physical Therapy Assistant in Kentucky

Sources for this page

Verify at the official NPI Registry.