| Organization Name: | KENTUCKY ORTHOPEDIC REHABILITATION LLC |
| NPI Number: | 1194932228 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL TARVIN (VICE PRESIDENT) |
| Mailing Address: | 875 Pennsylvania Ave Suite A Bardstown |
| State: | KY US |
| Postal Code: | 400042529 |
| Phone Number: | 5023496961 |
| Fax Number: | 5023491798 |
| NPI Enumeration Date: | 05/17/2007 |
| NPI Last Update Date: | 08/31/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |