1285804112 NPI number — KATHRYN SCHNEIDER ROY PT,DPT, ATC

Table of content: KATHRYN SCHNEIDER ROY PT,DPT, ATC (NPI 1285804112)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285804112 NPI number — KATHRYN SCHNEIDER ROY PT,DPT, ATC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROY
Provider First Name:
KATHRYN
Provider Middle Name:
SCHNEIDER
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PT,DPT, ATC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285804112
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/27/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5919 TIMBER RIDGE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PROSPECT
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40059-8132
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-292-0800
Provider Business Mailing Address Fax Number:
502-292-0400

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5919 TIMBER RIDGE DR
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
PROSPECT
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40059-8132
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-292-0800
Provider Business Practice Location Address Fax Number:
502-292-0400
Provider Enumeration Date:
03/06/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  5261 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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