Professional Physical Therapy Clinic LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PROFESSIONAL PHYSICAL THERAPY CLINIC LLC

Practice address

3415 Bardstown Rd Ste 307
Louisville, KY 40218-4633

Phone

(502) 712-1749

NPI assigned

Feb 24, 2016

Last updated

Feb 24, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Andrew Morrice Nankwenya

Title

Manager

Phone

(502) 712-1749

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1456272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456272000000",
    "number": "1851751473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3415 BARDSTOWN RD STE 307",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402184633",
            "telephone_number": "502-712-1749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 BARDSTOWN RD STE 307",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402184633",
            "telephone_number": "502-712-1749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL PHYSICAL THERAPY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-24",
        "last_updated": "2016-02-24",
        "status": "A",
        "authorized_official_last_name": "NANKWENYA",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "MORRICE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "502-712-1749",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Louisville, KY
• Providers in Louisville, KY by specialty
• Physical Therapy Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.