| Organization Name: | KENTUCKY ORTHOPEDIC REHABILITATION, LLC |
| NPI Number: | 1366548596 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL E. TARVIN (VICE PRESIDENT) |
| Mailing Address: | 815 Fairway Dr Suite C Brandenburg |
| State: | KY US |
| Postal Code: | 401081415 |
| Phone Number: | 7179754503 |
| Fax Number: | 7179759981 |
| NPI Enumeration Date: | 09/15/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation |
| Taxonomy Definition: | |